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The mechanism of action of the acute abnormal rise of plasma free fatty acids (FFA) in the provocation of arrhythmia in ischemic heart was studied by means of electron spin resonance (ESR) spectrometer. A sudden and abnormal rise of plasma FFA caused a significant fall of the respiratory control index (RCI) of the amount of free radical myocardial mitochondria in state 4 respiration. Based on these findings, a sudden and abnormal rise of plasma FFA seems to further facilitate the uncoupling of oxidative phosphorylation in the myocardial mitochondria of the ischemic portion of the heart. These observations indicate that it may play an important role in the provocation of arrhythmia by high plasma FFA on the ischemic heart. Nicomol (2,2,6,6,-tetrakis (nicotinoyloxymethyl) cyclohexanol), an inhibitor for the rapid rise of plasma FFA, was effective in the treatment and prevention of arrhythmia in ischemic heart disease and diabetes mellitus.
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