title: Efficacy of Precordial Percussion Pacing Assessed in a Cardiac Standstill Microminipig Model.
abstract: Potential cardiovascular benefits of precordial percussion pacing (PPP) during cardiac standstill are unknown.
  
  
  
  A cardiac standstill model in amicrominipigwas created by inducing complete atrioventricular block with a catheter ablation technique (n=7). Next, the efficacy of cardiopulmonary resuscitation by standard chest compressions (S-CPR), PPP and ventricular electrical pacing in this model were analyzed in series (n=4). To assess the mechanism of PPP, a non-selective, stretch-activated channel blocker, amiloride, was administered during PPP (n=3). Peak systolic and diastolic arterial pressures during S-CPR, PPP and ventricular electrical pacing were statistically similar. However, the duration of developed arterial pressure with PPP was comparable to that with ventricular electrical pacing, and significantly greater than that with S-CPR. Amiloride decreased the induction rate of ventricular electrical activity by PPP in a dose-related manner. Each animal survived without any neurological deficit at 24, 48 h and 1 week, even with up to 2 h of continuous PPP.
  
  
  
  In amicrominipigmodel of cardiac standstill, PPP can become a novel means to significantly improve physiological outcomes after cardiac standstill or symptomatic bradyarrhythmias in the absence of cardiac pacing. Activation of the non-selective stretch-activated channels may mediate some of the mechanophysiological effects of PPP. Further study of PPP by itself and together with S-CPR is warranted using cardiac arrest models of atrioventricular block and asystole.
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Toho University.|Department of Cardiology, Juntendo University School of Medicine.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Wada
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Toho University.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohara
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Toho University.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Toho University.
authors.forename: Xin
authors.initials: X
authors.lastname: Cao
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Toho University.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Izumi-Nakaseko
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Toho University.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ando
authors.affiliation: Department of General Medicine and Emergency Care, Faculty of Medicine, Toho University.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Honda
authors.affiliation: Department of General Medicine and Emergency Care, Faculty of Medicine, Toho University.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yoshihara
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Urayasu Hospital Heart Center.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakazato
authors.affiliation: Department of Emergency Medicine, University of Minnesota Medical School.
authors.forename: Keith G
authors.initials: KG
authors.lastname: Lurie
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Toho University.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugiyama
mesh_terms: D000818:Animals; D001283:Atrioventricular Node / Q000503:physiopathology / Q000601:surgery; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D008297:Male; D013552:Swine; D013556:Swine, Miniature
keywords: Cardiac standstill; Mechanophysiology; Microminipig; Precordial percussion pacing; Stretch-activated channels