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Electrophysiologic and arrhythmogenic effects of bupivacaine. A study with high-resolution ventricular epicardial mapping in rabbit hearts. 1992

J E de La Coussaye, and J Brugada, and M A Allessie
Department of Anesthesiology, University Hospital of Nîmes, France.

It has been shown that administration of toxic doses of bupivacaine may induce ventricular dysrhythmias. However, the mechanism of these dysrhythmias is still unknown. The present study was designed to test the hypothesis that bupivacaine facilitates the occurrence of reentrant ventricular dysrhythmias. High-resolution ventricular epicardial mapping was used to study the effects of 0.2, 0.5, 1.0, and 5.0 micrograms/ml bupivacaine in 11 Langendorff-perfused rabbit hearts. Five hearts were kept intact (intact heart). In six other hearts, a thin layer of epicardium was obtained by an endocardial cryotechnique (frozen heart). Bupivacaine induced ventricular dysrhythmias in 3 of 5 intact hearts at 5.0 micrograms/ml. In 3 of 6 frozen hearts, 0.2 micrograms/ml bupivacaine facilitated the induction of ventricular tachycardia by programmed electrical stimulation. Epicardial mapping showed that all tachycardias were based on reentry of the impulse around an arc of functional conduction block. Moreover, bupivacaine significantly prolonged the ventricular effective refractory period and slowed longitudinal and transverse conduction velocity in a dose- and use-dependent manner. It is concluded that bupivacaine facilitates induction of reentrant ventricular dysrhythmias in isolated rabbit heart.

UI MeSH Term Description Entries
D011817 Rabbits A burrowing plant-eating mammal with hind limbs that are longer than its fore limbs. It belongs to the family Leporidae of the order Lagomorpha, and in contrast to hares, possesses 22 instead of 24 pairs of chromosomes. Belgian Hare,New Zealand Rabbit,New Zealand Rabbits,New Zealand White Rabbit,Rabbit,Rabbit, Domestic,Chinchilla Rabbits,NZW Rabbits,New Zealand White Rabbits,Oryctolagus cuniculus,Chinchilla Rabbit,Domestic Rabbit,Domestic Rabbits,Hare, Belgian,NZW Rabbit,Rabbit, Chinchilla,Rabbit, NZW,Rabbit, New Zealand,Rabbits, Chinchilla,Rabbits, Domestic,Rabbits, NZW,Rabbits, New Zealand,Zealand Rabbit, New,Zealand Rabbits, New,cuniculus, Oryctolagus
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D004594 Electrophysiology The study of the generation and behavior of electrical charges in living organisms particularly the nervous system and the effects of electricity on living organisms.
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013610 Tachycardia Abnormally rapid heartbeat, usually with a HEART RATE above 100 beats per minute for adults. Tachycardia accompanied by disturbance in the cardiac depolarization (cardiac arrhythmia) is called tachyarrhythmia. Tachyarrhythmia,Tachyarrhythmias,Tachycardias
D014693 Ventricular Fibrillation A potentially lethal cardiac arrhythmia that is characterized by uncoordinated extremely rapid firing of electrical impulses (400-600/min) in HEART VENTRICLES. Such asynchronous ventricular quivering or fibrillation prevents any effective cardiac output and results in unconsciousness (SYNCOPE). It is one of the major electrocardiographic patterns seen with CARDIAC ARREST. Fibrillation, Ventricular,Fibrillations, Ventricular,Ventricular Fibrillations
D066298 In Vitro Techniques Methods to study reactions or processes taking place in an artificial environment outside the living organism. In Vitro Test,In Vitro Testing,In Vitro Tests,In Vitro as Topic,In Vitro,In Vitro Technique,In Vitro Testings,Technique, In Vitro,Techniques, In Vitro,Test, In Vitro,Testing, In Vitro,Testings, In Vitro,Tests, In Vitro,Vitro Testing, In

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