Deep anesthesia suppresses ventricular tachyarrhythmias in rabbit model of the acquired long QT syndrome.
BACKGROUND
Anesthesia sometimes suppresses ventricular tachyarrhythmias (VT) resistant to conventional pharmacological treatment.


RESULTS
To know (1) whether deep anesthesia inhibits abnormal repolarization-related VT and (2) if α2-adrenoreceptor (AR) agonistic action is associated with the antiarrhythmic effect of anesthetics, the incidence of VT in a rabbit model of acquired long QT syndrome using different anesthetic regimen was assessed. In Study 1 (n = 30), 15 rabbits were lightly anesthetized with ketamine (123 ± 46 mg/kg) and an α2-AR agonist, xylazine (9.4±3.0mg/kg), while combination of these anesthetics at high doses were used in the other 15 rabbits (343 ± 78 mg/kg and 38.9 ± 3.0 mg/kg). Administration of α1-AR stimulant, methoxamine and nifekalant (Ikr blocker) caused VT in all lightly anesthetized rabbits. In contrast, VT was observed only in 1 of the 15 deeply anesthetized rabbits (P < 0.01). In Study 2 (n = 15), 10 rabbits were anesthetized with high-dose ketamine and low-dose xylazine. In the other 5 rabbits, low-dose ketamine and high-dose xylazine were used. QTc interval in the latter was longer than that of the former (399 ± 56 ms vs. 494 ± 57 ms, P < 0.01). Although no VT appeared in high/low-rabbits, VT occurred in 3 out of 5 low/high-rabbits (P < 0.05).


CONCLUSIONS
These results suggest that (1) deep anesthesia suppresses abnormal repolarization-related VT and (2) antiarrhythmic effect of anesthesia on this type of VT is not dependent on α2-AR agonistic action.
Fourth Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Hideko
H
Inaba
Noriyuki
N
Hayami
Kosuke
K
Ajiki
Tomoyuki
T
Kunishima
Hidenori
H
Watanabe
Kenta
K
Tsutsui
Noboru
N
Yamagishi
Satoshi
S
Yamagishi
Anna
A
Sugiura
Takashi
T
Mikamo
Yuji
Y
Murakawa
D058647:Adrenergic alpha-2 Receptor Agonists / Q000494:pharmacology*; D000768:Anesthesia, General; D019162:Anesthetics, Combined / Q000494:pharmacology*; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology*; D001794:Blood Pressure; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D007649:Ketamine / Q000494:pharmacology*; D008133:Long QT Syndrome / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008729:Methoxamine; D011744:Pyrimidinones; D011817:Rabbits; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors; D014991:Xylazine / Q000494:pharmacology*
D058647:Adrenergic alpha-2 Receptor Agonists; D019162:Anesthetics, Combined; D000889:Anti-Arrhythmia Agents; D011744:Pyrimidinones; D014991:Xylazine; C076259:nifekalant; D007649:Ketamine; D008729:Methoxamine