Abstract 12042: Heart Rate Variability After Cardiac Arrest is Preserved by Whole Body Periodic Acceleration (pGz)
Predicting neurological outcome after brain injury or cardiac arrest (CA) is difficult. Heart Rate Variability (HRV) and lack thereof are markers for poor neurological outcome, and decreased HRV after CA correlates with poor outcomes. Whole Body Periodic Acceleration (pGz), the sinusoidal head to foot motion of the supine body with a motion platform increases endothelial derived NO (eNO) and neuronal nitric oxide (nNOS) in heart via pulsatile shear stress that produces pre and post conditioning of the heart from global and focal ischemia reperfusion injury (I/R). NO facilitates vagal chronotropism while inhibition of nNOS reduces HRV. We previously showed that pGz performed 1 hr prior to CA preserves HRV after CA. This study tests whether pGz applied after (postconditioning) CA can also preserve HRV in a pig model of CA. Eighteen male swine (40-50lbs) were anesthetized, intubated and instrumented to measure EKG and hemodynamics and randomized prior to CA to receive pGz (n=10) or none (CONT) (n=8). VF was electrically induced and unsupported for 8 min, followed by chest compression and defibrillation until return of spontaneous circulation (ROSC). We instituted pGz 10 min after ROSC using a motion platform (180 cpm and Gz ± 0.4). Short term HRV (excluding ectopic beats) was measured including; time domain; SDNN (standard deviation of normal to normal intervals), RMSSD (square root of the mean squared differences of successive normal to normal intervals) and frequency domain, at baseline (BL), and 30 to 180 min after ROSC (ROSC30, 60,120,180). All animals had ROSC after a median of 4 defibrillation attempts. There were no differences between groups in defibrillation attempts, time to ROSC, arterial blood gases or hemodynamics over time. Data mean ±SEM * p < 0.05 CONT vs pGz
Conclusion: pGz applied after CA in addition to being cardioprotective preserves HRV and is a novel non invasive method to preserve autonomic nervous system output while postconditioning the myocardium.
- Cardiopulmonary resuscitation
- Heart rate/Heart rate variability
- Post cardiac resuscitation
- Nitric oxide
Author Disclosures: J.A. Adams: Ownership Interest; Modest; Stock Options. A. Uryash: None. P. Pastuszko: None. A. Pastuszko: None. V. Nadkarni: None. P. Kurlansky: None.
- © 2014 by American Heart Association, Inc.