Cardiac Mechano-Electric Feedback and Arrhythmias

Introduction * Cardiac mechano-electric interactions and the induction & termination of arrhythmia Fundamental Mechanisms of Cardiac Mechano-Electric Feedback * Cardiac non-selective stretch-activated cation channels: pathophysiological potential * Mechanical modulation of cardiac potassium channels * Cell-volume activated ion channels in cardiac cells * Contribution of cytoskeleton and lipid bi-layer to cellular mechano-reception * The response of cardiac muscle to stretch: role of calcium * Stretch-effects on second messengers and early gene expression Cellular Effects of Mechano-Electric Feedback * Differential effects of stretch on cardiac cells in diastole and systole * Differential effects of stretch and compression of cardiac cells * Mechanical modulation of cardiac non-myocyte structure and function * Mechanical effects on auto- & paracrine signalling in cardiac myocytes and non-myocytes * Stretch effects on connexin expression in cardiac cells Mechano-Electric Feedback in Cardiac Tissue and Whole Heart * Mechanical modulation of sino-atrial pacemaking rate * Stretch effects on atrial conduction and refractoriness * Stretch effects on ventricular conduction and refractoriness * Neuro-humoral modulation of cardiac mechano-electric interactions * Mechanically-induced repolarization dispersion and the mechanical vulnerable period * Experimental arrhythmogenesis by acute mechanical stimulation (Commotio cordis) * Specific stretch-channel blockers: a new class of anti-arrhythmic drugs Clinical Evidence for Cardiac Mechano-Electric Feedback in Man * Non-neuronal component of respiratory sinus arrhythmia * Induction of arrhythmias by precordial impact * Arrhythmogenesis during cardiac catheterisation * Role of transmural gradients in mechano-electric interactions * Hemodynamic unloading and termination of arrhythmias * Bypass-induced ventricular load changes and action potential configuration * Termination of ventricular arrhythmia by acute mechanical interventions Clinical Relevance of Cardiac Mechano-Electric Feedback * Cardiac mechanics and the ECG U-wave * Arrhythmias in ischaemic heart disease in linkage with regional wall motion abnormalities * Arrhythmogenic potential of dysynergy of ventricular mechanics in patients with heart failure and wide QRS complex * Bi-ventricular pacing as a new treatment modality to restore ventricular synchronization * Atrial fibrillation in dilated cardiomyopathy * The angiotensin-renin pathway in left ventricular hypertrophy and SCD * Volume and pressure overload and ventricular arrhythmogenesis * Mortality from heart failure: haemodynamic versus electrical causes * Passive ventricular constraint: new treatment concept for dilated cardiomyopathy * Mechanical modulation of defibrillation efficacy by preload changes * Mechanical advances in cardiopulmonary resuscitation Clinical Trials Evaluating Survival Benefits by Ventricular Unloading or Resynchronization * Effects of bi-ventricular pacing on cardiac mortality and arrhythmias - the Companion trial * InSync Trial * Counter-pulsation and cardiac assist devices. * New intra-ventricular chamber reduction devices (Percutaneous catheter mediated endocardial ventriculoplasty for patients with heart failure). * Ventricular restraint study and reverse re-modeling in patients. * Evolving concepts in measuring ventricular stress-strain relations in the human heart Index