Evidence map›Paper›PMID 38939925›Full record

ArticleCirculation research2024

Antiarrhythmic Mechanisms of Epidural Blockade After Myocardial Infarction.

Jonathan D Hoang, Valerie Y H van Weperen, Ki-Woon Kang, Neil R Jani, Mohammed A Swid, Christopher A Chan, Zulfiqar Ali Lokhandwala, Robert L Lux, Marmar Vaseghi

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jonathan D HoangCardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, University of California, Los Angeles (UCLA) (J.D.H., V.Y.H.v.W., K.-W.K., N.R.J., M.A.S., C.A.C., Z.A.L., M.V.).
Valerie Y H van WeperenCardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, University of California, Los Angeles (UCLA) (J.D.H., V.Y.H.v.W., K.-W.K., N.R.J., M.A.S., C.A.C., Z.A.L., M.V.).
Ki-Woon KangCardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, University of California, Los Angeles (UCLA) (J.D.H., V.Y.H.v.W., K.-W.K., N.R.J., M.A.S., C.A.C., Z.A.L., M.V.).
Neil R JaniCardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, University of California, Los Angeles (UCLA) (J.D.H., V.Y.H.v.W., K.-W.K., N.R.J., M.A.S., C.A.C., Z.A.L., M.V.).
Mohammed A SwidCardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, University of California, Los Angeles (UCLA) (J.D.H., V.Y.H.v.W., K.-W.K., N.R.J., M.A.S., C.A.C., Z.A.L., M.V.).ORCID 0000-0002-0277-8719
Christopher A ChanCardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, University of California, Los Angeles (UCLA) (J.D.H., V.Y.H.v.W., K.-W.K., N.R.J., M.A.S., C.A.C., Z.A.L., M.V.).
Zulfiqar Ali LokhandwalaCardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, University of California, Los Angeles (UCLA) (J.D.H., V.Y.H.v.W., K.-W.K., N.R.J., M.A.S., C.A.C., Z.A.L., M.V.).ORCID 0000-0002-5000-4611
Robert L LuxDepartment of Medicine, The University of Utah, Salt Lake City (R.L.L.).
Marmar VaseghiCardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, University of California, Los Angeles (UCLA) (J.D.H., V.Y.H.v.W., K.-W.K., N.R.J., M.A.S., C.A.C., Z.A.L., M.V.).ORCID 0000-0002-9701-9706

Funding

Ventricular arrhythmias and mechanisms of parasympathetic dysfunction following myocardial infarctionR01HL148190 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI VASEGHI, MARMAR · 2020 to 2024
$3.2M
Sex differences in cardiac autonomic remodeling after myocardial infarctionR01HL170626 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Crystal May Ripplinger, Marmar Vaseghi · 2024 to 2026
$2.1M
NHLBI NIH HHS R01 HL148190NHLBI NIH HHS R01 HL170626
6 · The paper itself

Abstract

backgroundThoracic epidural anesthesia (TEA) has been shown to reduce the burden of ventricular tachycardia in small case series of patients with refractory ventricular tachyarrhythmias and cardiomyopathy. However, its electrophysiological and autonomic effects in diseased hearts remain unclear, and its use after myocardial infarction is limited by concerns for potential right ventricular dysfunction.

methodsMyocardial infarction was created in Yorkshire pigs (N=22) by left anterior descending coronary artery occlusion. Approximately, six weeks after myocardial infarction, an epidural catheter was placed at the C7-T1 vertebral level for injection of 2% lidocaine. Right and left ventricular hemodynamics were recorded using Millar pressure-conductance catheters, and ventricular activation recovery intervals (ARIs), a surrogate of action potential durations, by a 56-electrode sock and 64-electrode basket catheter. Hemodynamics and ARIs, baroreflex sensitivity and intrinsic cardiac neural activity, and ventricular effective refractory periods and slope of restitution (S

resultsTEA reduced inducibility of ventricular tachyarrhythmias by 70%. TEA did not affect right ventricular-systolic pressure or contractility, although left ventricular-systolic pressure and contractility decreased modestly. Global and regional ventricular ARIs increased, including in scar and border zone regions post-TEA. TEA reduced ARI dispersion specifically in border zone regions. Ventricular effective refractory periods prolonged significantly at critical sites of arrhythmogenesis, and S

conclusionsTEA does not compromise right ventricular function in infarcted hearts. Its antiarrhythmic mechanisms are mediated by increases in ventricular effective refractory period and ARIs, decreases in S

Indexed as

Myocardial InfarctionTachycardia, VentricularAnesthesia, EpiduralAnesthetics, LocalAnimalsAnti-Arrhythmia AgentsBaroreflexDisease Models, AnimalFemaleHemodynamicsLidocaineMaleMyocardial ContractionRefractory Period, ElectrophysiologicalSus scrofaSwineAnesthetics, LocalAnti-Arrhythmia AgentsLidocaineanesthesia, epiduralarrhythmias, cardiacautonomic nervous systemcardiac electrophysiologymyocardial infarctionperipheral nervous systemtranslational research

Identifiers

PMID38939925
PMCPMC11257785

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.