Ischemia acuta, riflessi neurovegetativi e fibrillazione ventricolare.

Translated title of the contribution: Acute ischemia, autonomic reflexes, and ventricular fibrillation

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The effects of the autonomic nervous system on malignant arrhythmias, particularly in the setting of ischemic heart disease, have been widely investigated and described. Specifically, while sympathetic hyperactivity is arrhythmogenic, an increased vagal activity often exerts a beneficial effect. New insights on the relationship between autonomic activity and sudden cardiac death have been obtained in conscious dogs in which a healed myocardial infarction, acute myocardial ischemia and exercise are combined. In this chronic animal model myocardial infarction reduces baroreflex sensitivity and heart rate variability (markers of vagal reflex and tonic activity to the heart) and a depressed baroreflex sensitivity or a reduced heart rate variability after myocardial infarction indicates an increased risk for ventricular fibrillation. The clinical relevance of these experimental observations was confirmed in studies in patients with myocardial infarction. Exercise training increases vagal control of heart rate and concomitantly prevents recurrence of ventricular fibrillation during acute ischemia in dogs susceptible to sudden death. The protective effect of vagal activity is further confirmed by the experimental evidence that electrical stimulation of the vagus is able to prevent ventricular fibrillation during acute myocardial ischemia. The possibility of modulating the autonomic control of cardiac activity by means of pharmacologic and non pharmacologic interventions able to increase cardiac vagal activity represents a rational and promising approach to reduce risk for lethal events after myocardial infarction.

Original languageItalian
Pages (from-to)215-220
Number of pages6
JournalCardiologia
Volume39
Issue number12 Suppl 1
Publication statusPublished - Dec 1994

Fingerprint

Ventricular Fibrillation
Reflex
Ischemia
Myocardial Infarction
Myocardial Ischemia
Baroreflex
Heart Rate
Dogs
Exercise
Autonomic Nervous System
Sudden Cardiac Death
Sudden Death
Electric Stimulation
Cardiac Arrhythmias
Animal Models
Recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ischemia acuta, riflessi neurovegetativi e fibrillazione ventricolare. / Vanoli, E.

In: Cardiologia, Vol. 39, No. 12 Suppl 1, 12.1994, p. 215-220.

Research output: Contribution to journalArticle

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