{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T04:08:04Z","timestamp":1794456484330,"version":"4.9.1"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,5,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Amiodarone is administered during resuscitation, but its antiarrhythmic effects during targeted temperature management are unknown. The purpose of this study was to determine the effect of both therapeutic hypothermia and amiodarone on arrhythmia substrates during resuscitation from cardiac arrest.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We utilized 2 complementary models: (1) In vitro no\u2010flow global ischemia canine left ventricular transmural wedge preparation. Wedges at different temperatures (36\u00b0C or 32\u00b0C) were given 5\u00a0\u00b5mol\/L amiodarone (36\u2010Amio or 32\u2010Amio, each n=8) and subsequently underwent ischemia and reperfusion. Results were compared with previous controls. Optical mapping was used to measure action potential duration, dispersion of repolarization (DOR), and conduction velocity (CV). (2) In vivo pig model of resuscitation. Pigs (control or targeted temperature management, 32\u201334\u00b0C) underwent ischemic cardiac arrest and were administered amiodarone (or not) after 8\u00a0minutes of ventricular fibrillation. In vitro: therapeutic hypothermia but not amiodarone prolonged action potential duration. During ischemia, DOR increased in the 32\u2010Amio group versus 32\u2010Alone (84\u00b17\u00a0ms versus 40\u00b17\u00a0ms,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05) while CV slowed in the 32\u2010Amio group. Amiodarone did not affect CV, DOR, or action potential duration during ischemia at 36\u00b0C. Conduction block was only observed at 36\u00b0C (5\/8 36\u2010Amio versus 6\/7 36\u2010Alone, 0\/8 32\u2010Amio, versus 0\/7 32\u2010Alone). In vivo: QTc decreased upon reperfusion from ischemia that was ameliorated by targeted temperature management. Amiodarone did not worsen DOR or CV. Amiodarone suppressed rearrest caused by ventricular fibrillation (7\/8 without amiodarone, 2\/7 with amiodarone,\n              <jats:italic>P<\/jats:italic>\n              =0.041), but not pulseless electrical activity (2\/8 without amiodarone, 5\/7 with amiodarone,\n              <jats:italic>P<\/jats:italic>\n              =0.13).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Although amiodarone abolishes a beneficial effect of therapeutic hypothermia on ischemia\u2010induced DOR and CV, it did not worsen susceptibility to ventricular tachycardia\/ventricular fibrillation during resuscitation.<\/jats:p>\n          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OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2002-8401","authenticated-orcid":false,"given":"Shalen","family":"Kouk","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and The Heart and Vascular Research Center MetroHealth Campus Case Western Reserve University Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Maleski","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and The Heart and Vascular Research Center MetroHealth Campus Case Western Reserve University Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Pawlowski","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and The Heart and Vascular Research Center MetroHealth Campus Case Western Reserve University Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6341-9656","authenticated-orcid":false,"given":"Kenneth R.","family":"Laurita","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and The Heart and Vascular Research Center MetroHealth Campus Case Western Reserve University Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance D.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and The Heart and Vascular Research Center MetroHealth Campus Case Western Reserve University Cleveland 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