Atrial function during cardiac arrest caused by ventricular fibrillation.
OBJECTIVE
To report observations on preserved regular atrial electrical and mechanical systole during ventricular fibrillation (VF) and to quantitate blood flow generated by atrial contractions in this setting.


METHODS
In 10 rats, right atrial pressure pulses were continuously recorded before and for an interval of 8 min after inducing VF. In 3 isolated, perfused rat hearts, epicardial right atrial electrograms were recorded after inducing VF. In 15 pigs, transesophageal echo-Doppler measurements were obtained with pulsed and color-Doppler visualization of flow across the mitral valve after onset of VF.


RESULTS
In each rat, regular right atrial pressure pulses were documented during VF. These persisted over an average interval of 7.5 min. In isolated, perfused hearts, right atrial contractions were accompanied by regular atrial depolarizations. In pigs, regular atrial contractions generated atrial stroke volumes of approximately 12 mL, or 25% of prearrest values during the first minute after onset of VF, but those declined to approximately 6 mL after 10 min of untreated cardiac arrest. Blood flow from the left atrium into the left ventricle failed to advance significantly into the systemic circuit. During atrial diastole, we observed reversal of flow into the left atrium.


CONCLUSIONS
Atrial contractions are preserved during the initial 8 min or more after cardiac arrest due to VF. Substantial forward flow into the left ventricle failed to advance through the outflow tract but regurgitated into the atrium during atrial diastole.
Pernat
A
A
Institute of Critical Care Medicine, Palm Springs, CA 92262-5309, USA.
Weil
M H
MH
Sun
S
S
Tang
W
W
Yamaguchi
H
H
Bisera
J
J
D000818:Animals; D016280:Atrial Function, Right / Q000502:physiology*; D001783:Blood Flow Velocity; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D006323:Heart Arrest / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006339:Heart Rate; D008297:Male; D009200:Myocardial Contraction; D051381:Rats; D017207:Rats, Sprague-Dawley; D013318:Stroke Volume; D013552:Swine; D014693:Ventricular Fibrillation / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology