Fatal ventricular fibrillation is a common complication of acute coronary syndromes. Effective preventive measures are not available. Immediate restriction of free fatty acid availability should optimize ischemic myocardial metabolism, reduce ventricular vulnerability, and increase glucose utilization. Rapid inhibition of lipoprotein lipase activity will achieve this. The clinical effects of antilipolytic treatment require further study.
2. Norris RM. Fatality outside hospital from acute coronary events in three British health district hospitals, 1994-5. Br Med J316:1065-1070, 2000
3.
3. Singh BN, Wellens HJJ, Hiraoka M. Electropharmacological control of cardiac arrhythmias: To delay conduction or to prolong refractoriness. J Cardiovasc Electrophysiol5:722-730, 1994
4.
4. Misier ARR, Opthof T, van Hemel NM, et al. Dispersion of ‘refractoriness’ in noninfarcted myocardium of patients with ventricular tachycardia or ventricular fibrillation after myocardial infarction. Circulation92:1589-1597, 1995
5.
5. Wellens HJ. 1967-1997: Thirty years of cardiac arrhythmias. Eur Heart J19:984-989, 1998
6.
6. Ferrari R, Pepi P, Ferrari F, et al. Metabolic derangement in ischemic heart disease and its therapeutic control. Am J Cardiol82:2K-13K, 1998
7.
7. Taegtmeyer H. Modulation of responses to myocardial ischemia: Metabolic features of myocardial stunning, hibemation, and ischemic preconditioning. In Dilsizian V (ed). Myocardial Viability: A clinical and Scientific Treatise. Futura Publishing, Armonk, NY, pp. 25-35, 2000
8.
8. Touboul P. A decade of clinical trials: CAST to AVID. In Camm AJ, Aliot E (eds). Evidence base for the treatment of life-threatening arrhythmias. Eur Heart J (Suppl C), 1-10, 1999
9.
9. Vetter NJ, Strange RC, Adams W, et al. Initial metabolic and hormonal response to acute myocardial infarction. Lanceti:284-288, 1974
10.
10. Valori C, Thomas M, Shillingford J. Free noradrenaline and adrenaline excretion in relation to clinical syndromes following myocardial infarction. Am J Cardiol20:605-612, 1967
11.
11. Kurien VA, Oliver MF. Serum-free-fatty-acids after acute myocardial infarction and cerebral vascular occlusion. Lancetii: 122-127, 1966
12.
12. Opie LH. Metabolism of free fatty acids, glucose and catecholamines in acute myocardial infarction. Am J Cardiol36:938-953, 1975
13.
13. Mueller HS, Ayres SM. Metabolic responses of the heart in acute myocardial infarction in man. Am J Cardiol42:363-371, 1978
14.
14. Neely JR, Morgan HE. Relationship between carbohydrate and lipid metabolism and the energy balance of the heart. Ann Rev Physiol36:413-459, 1974
15.
15. Taegtmeyer H, Russell RR. Essential fuels for the heart and mechanical restitution. In Dilsizian V (ed). Myocardial Viability: A Clinical and Scientific Treatise. Futura Publishing, Armonk, NY; pp. 91-104, 2000
16.
16. Lopaschuk GD. Optimizing cardiac energy metabolism: A new approach to treating ischaemic heart disease. Eur Heart J1(Suppl 0):032-039, 1999
17.
17. Oliver MF, Opie LH. Effects of glucose and fatty acids on myocardial ischaemia and arrhythmias. Lancet343:155-158, 1994
18.
18. Mjos OD. Effect of free fatty acids on myocardial functions and oxygen consumption in intact dogs. J Clin Invest50:1386-1389, 1971
19.
19. Bonnet D, Martin D, de Lonlay P, et al. Arrhythmias and conduction defects as presenting symptoms of fatty acid oxidation disorders in children. Circulation100:2248-2253, 1999
20.
20. Kantor PF, Dyck JRB, Lopaschuk GD. Fatty acid oxidation in the perfused ischemic heart. Am J Med Sci318:3-14, 1999
21.
21. Oliver MF, Kurien VA, Greenwood TW. Relation between serum free fatty acids and arrhythmias and death after acute myocardial infarction. Lanceti:710-715, 1968
22.
22. Spector AA. The transport and utilization of free fatty acid. Ann NYAcad Sci149:768-778, 1968
23.
23. Kurien VA, Oliver MF. A metabolic cause for arrhythmias during acute myocardial hypoxia. Lancetii:813-815, 1970
24.
24. Tansey MJB, Opie LH. Relation between plasma free fatty acids and arrhythmias within the first twelve hours of acute myocardial infarction. Lancetii:419-422, 1983
25.
25. Kurien VA, Yates PA, Oliver MF. The role of free fatty acids in the production of ventricular arrhythmias after acute coronary artery occlusion. Eur J Clin Invest1:225-241, 1971
26.
26. Soloff LA. Arrhythmias following infusions of fatty acids. Am Heart J80:671-674, 1970
27.
27. McLennan PL, Bridle TM, Abeywardena MY, et al. Dietary lipid modulation of ventricular fibrillation threshold in the marmoset monkey. Am Heart J123:1555-1561, 1992
28.
28. Billman GE, Kang JX, Leaf AS. Prevention of sudden cardiac death by dietary pure o-3 polyunsaturated fatty acids in dogs. Circulation99:2452-2457, 1999
29.
29. Sparagna GC, Hickson-Bick DL. Cardiac fatty acid metabolism and the induction of apoptosis. Am J Med Sci318:15-21, 1999
31. Rowe MJ, Neilson JMM, Oliver MF. Control of ventricular arrhythmias during myocardial infarction by antilipolytic treatment using a nicotinic acid analogue. Lanceti:295-302, 1975
32.
32. Kjekshus JK, MjOs OD. Effect of inhibition of lipolysis on infarct size after experimental coronary artery occlusion. J Clin Invest52:1770-1776, 1973
33.
33. Luxton MR, Miller NE, Oliver MF. Anti-lipolytic therapy in angina pectoris: Reduction of exercise-induced ST segment depression. Br Heart J38:1204-1208, 1976
34.
34. Freemantle N, Cleland J, Young P, et al. n-blockade after myocardial infarction: Systematic review and meta regression analysis. Br Med J318:1730-1737, 1999
35.
35. Bagger JP, Botker HE, Thomassen A, et al. Effects of ranolazine on ischemic threshold, coronary sinus blood flow and myocardial metabolism in coronary artery disease. Cardiovasc Drug Ther11:479-484, 1997
36.
36. Apstein CS, Opie LH. Glucose-insulin-potassium (GIK) for acute myocardial infarction: A negative study with a positive value. Cardiovasc Drug Ther13:185-189, 1999
37.
37. Olivecrona T, Olivecrona G. Lipoprotein and hepatic lipase in lipoprotein metabolism. In Betteridge DJ, Illingworth DR, Shepherd J (eds). Lipoproteins in Health and Disease. Arnold, London, 1999
38.
38. Lopaschuk GD. Treating ischemic heart disease by pharmacologically improving cardiac energy metabolism. Am J Cardiol82: 14K-17K, 1998
39.
39. Diaz R, Paolasso EC, Piegas LS. Metabolic modulation of acute myocardial infarction. The ECLA glucose-insulinpotassium pilot trial. Circulation98:2227-2234, 1998
40.
40. Malmberg K, for the DIGAMI group. Prospective randomised study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus. Br Med J314:1512-1515, 1997
41.
41. Sayer JW, Archbold RA, Wilkinson P, et al. Prognostic implications of ventricular fibrillation in acute myocardial infarction: New strategies required for further mortality reduction. Heart84:258-261, 2000
