Prevention of life-threatening arrhythmias by pharmacologic stimulation of the muscarinic receptors with oxotremorine

Geatano M. De Ferrari, Emilio Vanoli, Paola Curcuruto, Gianluca Tommasini, Peter J. Schwartz

Research output: Contribution to journalArticlepeer-review

Abstract

The potential antiarrhythmic efficacy of pharmacologic parasympathetic activation is still controversial. This study assessed the antiarrhythmic effect of saline solution (n = 9) and of the muscarinic agonist oxotremorine (1.5 μg/kg administered intravenously) (n = 17) in a feline animal model in which malignant arrhythmias were reproducibly elicited by the combination of acute myocardial ischemia and left stellate ganglion stimulation. Although saline solution had no effect, oxotremorine significantly decreased heart rate, blood pressure, the incidence of ventricular fibrillation from 47% to 0% (p = 0.004), and the incidence of malignant arrhythmias (either ventricular tachycardia or ventricular fibrillation) from 88% to 12% (p <0.001). When reduction in heart rate was prevented by means of atrial pacing (n = 15), the incidence of malignant arrhythmias was still significantly reduced from 87% to 27% (p = 0.001). Arrhythmias were also graded as follows: 0 = no premature ventricular contractions; 1 = 1 to 10 premature ventricular contractions; 2 = 11 to 50 premature ventricular contractions; 3 = ventricular tachycardia; 4 = ventricular fibrillation. Arrhythmia severity was 3.29 ± 0.16 (SEM) in the control trials and was reduced to 0.76 ± 0.26 (p <0.001) by oxotremorine and to 1.53 ± 0.34 by oxotremorine and pacing (p = 0.002). Therefore a muscarinic agonist can significantly reduce malignant arrhythmias during acute myocardial ischemia and may represent a novel approach to the prevention of sudden cardiac death.

Original languageEnglish
Pages (from-to)883-890
Number of pages8
JournalAmerican Heart Journal
Volume124
Issue number4
DOIs
Publication statusPublished - 1992

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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