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2 . 2021

Treatment of heart rhythm disorders by increasing the focus of initial excitation in the synoatrial node (experimental study)

Abstract

The aim: search for alternative approaches to the treatment of cardiac arrhythmias based on the suppression of the spontaneous activity of pacemaker cells of the sinus node through an increase in the focus of initial excitation in the sinoatrial region of the heart.

Results. The observations were carried out in 10 rabbits. The rabbit was fixed in the machine. An electrocardiogram was recorded. The area of the right auricle was injected with two fixed, needle-like, hook-shaped electrodes. Volleys of electrical impulses came from the electrostimulator through an insulating block. In 6 rabbits, the initial rhythm was sinus, and in 4, sinus arrhythmia was observed. When stimulating the reflexogenic zone with bursts of 4 electrical impulses (pulse duration of 2 milliseconds, pulse frequency in bursts of 80 Hz) in the frequency range 173.5±2.0 - 214.0±1.8 per minute, synchronization was observed between the frequency of bursts and heart rate. For each volley applied to the reflexogenic zone of the auricle, the heart made one contraction. The change in the frequency of volleys led to a synchronous change in the heart rate. The ability to control the heart rate was created. The arrhythmia disappeared. There was no synchronization outside the range. With 8 pulses in a salvo, the synchronization range was 165.8±2.2 - 210.3±2.4 per minute. There was no effect outside the reflexogenic zone. With 8 pulses in salvos, the synchronization range was greater than with 4 pulses.

Conclusion. Increasing the area of the early depolarization zone in the sinoatrial region by percutaneous stimulation of the reflexogenic zone of the auricle with volleys of electrical impulses, is a promising approach for the treatment of cardiac arrhythmias.

Keywords:sinoatrial node, early depolarization zone

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Nechepurenko A.A., Tarasov D.G., Pokrovsky V.M., Galenko-Yaroshevsky P.A., Korotkov K.G., Suzdalev K.F., Lebedeva S.A., Minkin V.A., Maslova P.D., Cherednik I.L., Abushkevich V.G. Treatment of heart rhythm disorders by increasing the focus of initial excitation in the synoatrial node (experimental study). Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (2): 84-9. DOI: https://doi.org/10.33029/2308-1198-2021-9-2-84-89 (in Russian)

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CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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