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Boban, M; Atlee, JL; Vicenzi, M; Kampine, JP; Bosnjak, ZJ.
Anesthetics and automaticity in latent pacemaker fibers. IV. Effects of isoflurane and epinephrine or norepinephrine on automaticity of dominant and subsidiary atrial pacemakers in the canine heart.
Anesthesiology. 1993; 79(3): 555-562. Doi: 10.1097/00000542-199309000-00020 [OPEN ACCESS]
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Co-authors Med Uni Graz: Vicenzi Martin
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Abstract:: BACKGROUND: Anesthesia and surgery may be associated with atrioventricular junctional or ventricular rhythm disturbances. These may be caused by alteration of automaticity of primary and subsidiary pacemakers. METHODS: The direct effects of isoflurane, alone or in combination with epinephrine (E) and norepinephrine (NE), as well as single effects of E and NE, were examined on automaticity of primary and subsidiary atrial pacemakers (SAP) using a perfused canine right atrial preparation (n = 29). Preparations were perfused with oxygenated Krebs' solution at a constant perfusion pressure of 87 mmHg and a temperature of 36.5 +/- 0.5 degrees C. Delivered concentrations of isoflurane of 1.4 and 2.8% corresponded to measured perfusate concentrations of 315 +/- 7 and 617 +/- 16 microM in experiments with E (n = 14), and 316 +/- 10 and 610 +/- 26 microM in experiments with NE (n = 15). Epinephrine or NE perfusate concentrations were 2 and 5 micrograms/l or 5 and 10 micrograms/l, respectively. To determine the site of earliest activation, extracellular recordings were made from the SA node region and distal sites (approximately 1, 2, and 3 cm) along the sulcus terminalis, the previously reported locations of SAP. Sites of earliest activation shifts from SA node to SAP were scored 1, 2, or 3 depending on the distance from the control pacemaker. The summed shift scores (magnitude score) were normalized by dividing by the total number of preparations for each experimental condition. RESULTS: Exposure to isoflurane, NE, or E alone did not produce a significant increase in the incidence of pacemaker shifts or normalized pacemaker shift scores. Only the high dose of E significantly increased the incidence of pacemaker shifts and normalized shift scores. Dysrhythmogenic potential of E and NE tended to be greater after earlier exposure to isoflurane. Every combination of isoflurane with E or NE produced a significant increase in the incidence of pacemaker shifts and normalized shift scores. CONCLUSIONS: It was concluded that isoflurane with E or NE acts synergistically to increase dysrhythmic potential in the arterial tissue.
Find related publications in this database (using NLM MeSH Indexing): Animals -; Dogs -; Epinephrine - pharmacology; Female -; Isoflurane - pharmacology; Male -; Norepinephrine - pharmacology; Sinoatrial Node - drug effects Sinoatrial Node - physiology
Find related publications in this database (Keywords): ANESTHETICS, VOLATILE, ISOFLURANE; ANIMAL, DOG; HEART, ARRHYTHMIAS; ELECTROPHYSIOLOGY; SINUS NODE; SUBSIDIARY ATRIAL PACEMAKERS; SYMPATHETIC NERVOUS SYSTEM, CATECHOLAMINES