The intracellular sodium concentration reported for young, embryonic chick hearts is extremely high and decreases progressively throughout the embryonic period, reaching a value of 43 mM immediately before hatching. This observation suggested that the ionic basis for excitation in embryonic chick heart may differ from that responsible for electrical activity of the adult organ. This hypothesis was tested by recording transmembrane resting and action potentials on hearts isolated from 6-day and 19-day chick embryos and varying the extracellular sodium and potassium concentrations. The results show that for both young and old embryonic cardiac cells the resting potential depends primarily on the extracellular potassium concentration and the amplitude and rate of rise of the action potential depend primarily on the extracellular sodium concentration.

Action Potentials↗

PubMedDate not supplied

Support of cardiac performance following heart valve surgery by raising heart rate to the optimal pacing rate.

Effects of hemodynamic parameters of heart rate were studied in 19 patients with low cardiac output syndrome following open heart surgery for mitral and/or aortic valve replacement in the first five postoperative days. The central venous pressure (CVP), left atrial mean pressure (LAMP), and arterial blood pressures were determined at spontaneous heart rate (SHR), and during graded atrial (12 pts.) or ventricular (7 pts.) pacing each day. An "optimal pacing rate" (OPR), characterized by the most advantageous arterial pressures at the possible lowest levels of CVP and LAMP, and by the suppression of preexisting arrhythmias, if any, was established daily for maintaining each patient on that rate. The SHR was 69 +/- 9 and the OPR was 102 +/- 9 on the first postoperative day. For the fifth postoperative day the SHR was 68 +/- 10 and the OPR decreased to 90 +/- 9. Pacing with the OPR significantly increased cardiac performance. E.g. the hemodynamic improvement on the first postoperative day induced by pacing was comparable to the spontaneous improvement seen during the first five postoperative days. The hemodynamic effect of atrial pacing on circulation was more definitive than that of ventricular pacing. Since OPR may be significantly higher than SHR and varies from day to day, we suggest that, in cases where pacing is applied to improve cardiac performance, it be determined for each patient individually each postoperative day.

Adolescent↗