Autonomic dysfunction and phase 2 ventricular fibrillation post myocardial infarction
Abstract Category: Science
Course / Degree: MSc Pharmacology
Institution / University: Kings College London, University of London , United Kingdom
Published in: 2005
Sudden cardiac death (SCD) claims 100,000 lives in the UK and over 400,000 in the USA. In humans the spatial and temporal patterns of ventricular fibrillation (VF) are poorly characterised .However, if VF is phase dependant like it is in animal models, then phase 2 VF would account for 87 % of VF related sudden cardiac deaths in humans. This would explain why most deaths (50-80 %) in the clinical setting occur within the first hours of the onset of myocardial ischaemia. In animal models the timing of susceptibility to VF is well characterised. In every animal model examined to date ventricular fibrillation exhibits 2 phases. The acute phase of VF, Phase 1 VF, occurs early in the first 30 minutes of ischeamia and the late phase of VF, defined as phase 2 VF, occurs when irreversible myocardial necrosis sets in after more than 90 min of ischaemia. In animal models the second phase is by far the most lethal phase. Ironically, the pathophysiological mechanisms underlying phase 2 VF are poorly understood and it remains a neglected therapeutic target. There is an ever-growing body of evidence suggesting that heightened sympathetic activity combined with diminished parasympathetic activity may be the pathophysiological mechanism underlying the onset of phase 2 VF. By reviewing a range of different types of data we have outlined the likely mechanisms of phase 2 VF and have evaluated some of the evidence available that suggests that the autonomic nervous system dysfunction is the mechanism-underlying phase 2 VF post myocardial infarction. We have also extensively reviewed the current models that have been used for the study of phase 2 VF. We conclude by evaluating possible future directions to help evolve a strategy for the pharmacological suppression of phase 2 VF.
Dissertation Keywords/Search Tags:
Acute myocardial infarction, antiarrhythmic, arrhythmia, myocardial ischaemia, phase 2 ventricular fibrillation, proarrhythmia, sudden cardiac death
This Dissertation Abstract may be cited as follows:
MUGERA C.M. & CURTIS M.J. (2005)
Submission Details: Dissertation Abstract submitted by Charles Mugera from United States on 24-Aug-2010 19:23.
Abstract has been viewed 3104 times (since 7 Mar 2010).
Charles Mugera Contact Details: Email: mutithi@yahoo.com Phone: 4102277261
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