Ann Thorac Surg 1984;37:154-158
© 1984 The Society of Thoracic Surgeons
Articles
Differential Electrical Activity of the Atria during Cardioplegic Arrest in Pigs
Richard J. Novick, M.D.,
Henry J. Stefaniszyn, M.D.,
Ian D. Malcolm, M.D.,
France D. Burdon, B.S.,
Tomas A. Salerno, M.D.*
From the Division of Cardiovascular and Thoracic Surgery, the Cardiovascular Research Unit, and the Department of Medicine (Cardiology), McGill University and the Royal Victoria Hospital, Montreal, Que, Canada
Accepted for publication April 20, 1983.
* Address reprint requests to Dr. Salerno, Division of Cardiovascular Surgery, St. Michael's Hospital, 30 Bond St, Toronto, ant, Canada M5B 1W8
 |
Abstract
|
|---|
To elucidate the electrical interrelationship of the atria during cardioplegic arrest, simultaneous bipolar right atrial (RA) and left atrial (LA) electrograms and myocardial temperatures of all four chambers of the heart were recorded in 10 pigs during an hour of aortic clamping. Five pigs (Group 1) underwent single venous cannulation; in 5 others (Group 2), snared double caval cannulation, RA venting, and intracavitary RA irrigation with cold saline solution were employed. Myocardial protection was provided by systemic hypothermia (28°C) and intermittent intraaortic administration of cold (4°C) hyperkalemic (20 mEqlL) crystalloid cardioplegic solution.
Single RA cannulation was associated with sustained RA activity during cardioplegic arrest and with the warmest mean myocardial temperatures. Electrical activity was infrequent in the left atrium, which was often silent while RA impulses continued to be observed. Four Group 1 pigs exhibited high-grade RA-LA block, whereas in 2 animals completely asynchronous RA-LA electrical activity occurred. Isolated LA activity was not encountered. The combined methods used in Group 2 pigs significantly reduced mean myocardial temperatures. Both RA and LA impulses were practically abolished, and their mean durations decreased 96% and 85%, respectively.
It is concluded that the pattern of electrical activity differs in the two atria during cardioplegic arrest when a single venous cannula is employed. Intracavitary RA irrigation with cold saline solution in the presence of snared caval cannulas provides improved myocardial hypothermia and effectively eliminates both RA and LA activity in the course of cold crystalloid cardioplegia.
|
Footnotes
|
|---|
Supported by a grant from the Quebec Heart Foundation and Grant MA-7870 from the Medical Research Council of Canada.
We acknowledge the assistance of Mrs. Susan Anderson in manuscript preparation.
|
References
|
|---|
- Tchervenkov CI, Wynands JE, Symes JF, et al. Electrical recovery of the heart following high potassium cardioplegia Surg Forum 1982;33:304.
- Smith PK, Buhrman WC, Levett JM, et al. Supraventricular conduction abnormalities following cardiac operations J Thorac Cardiovasc Surg 1983;85:105.[Medline]
- Tchervenkov CI, Wynands JE, Symes JF, et al. Persistent atrial activity during cardioplegic arrest: a possible factor in the etiology of postoperative supraventricular tachyarrhythmias Ann Thorac Surg 1983;36:437.[Abstract/Free Full Text]
- Novick RJ, Stefaniszyn HJ, Morin JE, et al. Atrial electrical activity and its suppression during cardioplegic arrest in pigs J Thorac Cardiovasc Surg 1983;86:235.[Abstract]
- Waldo AL, MacLean WAH. Placement and care of temporary epicardial wire electrodes. In Diagnosis and Treatment of Cardiac Arrhythmias Following Open Heart Surgery: Emphasis on the Use of Atrial and Ventricular Epicardial Wire Electrodes. Mt. Kisco, NY: Futura; 1980. pp. 1-19.
- Cohen J, Scherf D. Complete interatrial and intraatrial block (atrial dissociation) Am Heart J 1965;70:23.[Medline]
- James TN, Sherf L. Specialized tissues and preferential conduction in the atria of the heart Am J Cardiol 1971;28:414.[Medline]
- Legato MJ, Ferrer MI. Intermittent intra-atrial block: its diagnosis, incidence, and implications Chest 1974;65:243.[Medline]
- Holsinger JW, Wallace AG, Sealy WC. The identification and surgical significance of the atrial internodal conduction tracts Ann Surg 1968;167:447.[Medline]
- Wagner ML, Hoffman BF. The role of the interatrial band in interatrial conduction Fed Proc 1965;24:212.
- Wagner ML, Lazzara R, Weiss RM, Hoffman BF. Specialized conducting fibers in the interatrial band Circ Res 1966;18:502.[Abstract/Free Full Text]
- Bachmann G. The interauricular time interval Am J Physiol 1916;41:309.[Free Full Text]
- James TN. The connecting pathways between the sinus node and A-V node and between the right and left atrium in the human heart Am Heart J 1963;66:498.[Medline]
- Vassalle M, Hoffman BF. The spread of sinus activation during potassium administration Circ Res 1965;17:285.[Abstract/Free Full Text]
- Marshall JM. Effects of low temperatures on transmembrane potentials of single fibers of the rabbit atrium Circ Res 1957;5:664.[Abstract/Free Full Text]
- De Mello WC, Hoffman BF. Potassium ions and electrical activity of specialized cardiac fibers Am J Physiol 1960;199:1125.[Abstract/Free Full Text]
This article has been cited by other articles:
|
|
|
|
 
M. Dewar, M. D. Rosengarten, R. Samson, C. Wittnich, P. E. Blundell, and R. C.- J. Chiu
Is High Potassium Solution Necessary for Reinfusions in "Multidose" Cold Cardioplegia? A Randomized Prospective Study Using Computerized Holter System
Ann. Thorac. Surg.,
April 1, 1987;
43(4):
409 - 415.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. M. Peniston, P. A. Spence, N. Mihic, A. K. Jabr, M. McLennan, V. Yap, and T. A. Salerno
The Effects of Cardioplegic Arrest on Right Atrial Function
Ann. Thorac. Surg.,
May 1, 1986;
41(5):
473 - 477.
[Abstract]
[PDF]
|
|
|
Top
Abstract
Footnotes
