IMPULSE PROPAGATION AT ISCHEMIA BOUNDARIES

缺血边界处的脉冲传播

• 批准号: 3736283
• 负责人: WAYNE E CASCIO
• 金额: --
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3736283
• 关键词: acidity /alkalinity; calcium flux; carbon dioxide tension; catecholamines; cell cell interaction; cell death; cellular polarity; confocal scanning microscopy; electrophysiology; laboratory rabbit; myocardial ischemia /hypoxia; neural transmission; oxygen tension; premature ventricular contractions; sudden cardiac death; ventricular fibrillation; video microscopy

The aims of this study are: 1) to identify patients at highest risk of sudden death from ventricular arrhythmia following an acute myocardial infarction, and 2) to reduce the incidence of this complication in those patients identified to be at highest risk. The study population will consist of approximately 425 survivors of myocardial infarction who have one or more conventional risk factors for subsequent sudden cardiac death. These patients will receive electrophysiologic study (EPS) with programmed ventricular stimulation; Up to 3 ventricular extrastimuli will be administered in an attempt to induce ventricular tachycardia (VT). Those patients without inducible VT will be teated with a beta adrenergic blocking agent only. Of the patients with inducible VT at EPS, one group will receive beta blockade therapy only, while another group will receive EPS-guided antiarrhythmic therapy in additional to beta blockade. These three groups will be followed long-term to determine whether the results of EPS predict subsequent sudden cardiac death more accurately than current techniques, and whether prophylactic therapy guided by EPS can prevent sudden cardiac death in susceptible patients.

本研究的目的是：1）识别风险最高的患者 急性心律失常后因室性心律失常猝死的 心肌梗塞，2) 减少这种情况的发生 那些被确定为风险最高的患者的并发症。 研究人群将包括大约 425 名幸存者 患有一种或多种常规风险的心肌梗塞 随后发生心源性猝死的因素。 这些患者将 接受电生理学研究（EPS） 心室刺激；最多 3 次心室额外刺激 试图诱发室性心动过速 （VT）。 那些没有诱导性 VT 的患者将接受 仅β肾上腺素能阻滞剂。 患者中有 EPS 时可诱导 VT，一组将接受 β 阻断治疗 仅，而另一组将接受 EPS 引导的抗心律失常药物 除β受体阻滞剂外的治疗。 这三组将 长期跟踪以确定 EPS 的结果是否 比预测随后的心源性猝死更准确 目前的技术，以及预防性治疗是否以 EPS可以预防易感患者的心源性猝死。