Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny)Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny)2070-9277Voronezh State Medical University named after N.N. Burdenko - The State Budgetary Institution of Higher Professional Education «Voronezh State Medical University named after N.N. Burdenko» of the Ministry of Public Health of the Russian1010910.18499/2070-9277-2024-27-2-67-72Original ArticleRole of sodium ions in the appearance of ventricular fibrillation of the heartAlabovskyVladimir Vladimirovich<p>Doctor of Medical Sciences, Professor of the Department of Clinical Laboratory Diagnostics</p>v.alabovsky@yandex.ruVinokurovAlexey Anatolyevich<p>PhD, Assistant of the Department of Clinical Laboratory Diagnostics</p>alwin66@rambler.ruMaslovOleg Vladimirovich<p>PhD, Associate Professor of the Department of Clinical Laboratory Diagnostics</p>maslov-oleg1205@mail.ruArustamyanAngelica Arkadyevna<p>student</p>arustamyan_lika@mail.ruZemchenkovaOlga Vladimirovna<p>PhD, Associate Professor of the Department of Clinical Laboratory Diagnostics</p>zov-bio@mail.ruPopovaLudmila Ivanovna<p>PhD, Associate Professor of the Department of Clinical Laboratory Diagnostics</p>popova_li_bh@mail.ruVSMU named after N.N. Burdenko28062024272677209072024Copyright © 2024, Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny)2024<p>A method has been proposed for simulating ventricular fibrillation of the heart by reducing the concentration of sodium chloride in the perfusion solution. It was revealed that a decrease in NaCl concentration to 30 mmol/l was accompanied by the occurrence of fibrillation. The development of fibrillation was preceded by an increase in the amplitude of cardiac contractions and the appearance of presystole, which indicates an overload of the myocardium with Ca2⁺ ions by activating the calcium flow into cardiomyocytes using Na⁺-Ca2⁺ exchange. Slow calcium channel inhibitors did not prevent fibrillation. It was shown that a decrease in the level of K+ and an increase in the concentration of Ca2⁺ in the perfusion solution contributed to the acceleration of the development of arrhythmia and, conversely, an increase in the concentration of K⁺ or a decrease in the concentration of Ca2⁺ slowed down its development or completely prevented it.</p> <p>The use of this technique on other animals: rabbits, guinea pigs, dogs was also accompanied by the occurrence of fibrillation.</p> <p>Thus, according to the results obtained, we can conclude that the Na⁺-Ca2⁺ metabolic mechanism is directly involved in the occurrence of ventricular fibrillation of the heart.</p>Na+−Ca2+ exchange, slow calcium channels, ventricular fibrillation, calcium channel inhibitors.Nа+−Са2+ обмен, медленные кальциевые каналы, фибрилляция желудочков сердца, ингибиторы кальциевых каналов.1.1. Eckart R. E.; Shry E. A.; Burke A. P.; McNear J. A.; Appel D. A.; Castillo-Rojas L. M.; Avedissian L; Pearse L. A.; Potter R N. Sudden Death in Young Adults. Journal of the American College of Cardiology. 2011. 58 (12): 1254–12612.2. Chockalingam P. Idiopathic Ventricular Fibrillation: Preventable Cause of Sudden Cardiac Death in Need of Global Collaboration. JACC Clin Electrophysiol. 2023 Aug;9(8 Pt 1):1307-1309. doi: 10.1016/j.jacep.2023.04.019. Epub 2023 Jun 21. PMID: 37354180.3.3. Мильман А., Белхассен Б., Ноф Э., Барбаш И., Сегев А., Бейнарт Р. Идиопатическая фибрилляция желудочков или ишемическая фибрилляция желудочков? Isr Med Assoc J. 2023 ноябрь; 25(11):763-765. ПМИД: 37980624.4.4. Райскина М.Е., Онищенко Н.А. Шарогородский Б.М., Халимова К.М., Фельд Б.Н., Расторгуев Б.П. Методы прижизненного исследования метаболизма сердца., «Медицина». Москва. 1970, 264 с.5.5. Гоффман Б., Крейнфилд П. Электрофизиология сердца. М. Медицина.1962, 390 с.6.6. Krstic AM, Power AS, Ward ML. Visualization of Dynamic Mitochondrial Calcium Fluxes in Isolated Cardiomyocytes. Front Physiol. 2022 Jan 24;12:808798. doi: 10.3389/fphys.2021.808798. PMID: 35140632; PMCID: PMC8818789.7.7. Keefe, J.A.; Moore, O.M.; Ho, K.S.; Wehrens, X.H.T. Role of Ca2+ in healthy and pathologic cardiac function: From normal excitation-contraction coupling to mutations that cause inherited arrhythmia. Arch. Toxicol. 2023, 97, 73–92.8.8. Medeiros T, Bui V, Almekdash MH, Keesari R, Lee YR. Rate control with intravenous diltiazem, verapamil, and metoprolol in acute atrial fibrillation with rapid ventricular rate. SAGE Open Med. 2021 May 25;9:20503121211017756. doi: 10.1177/20503121211017756. PMID: 34104435; PMCID: PMC8155749.9.9. Benz AP, Hohnloser SH. Is there a role for verapamil beyond rate control in paroxysmal atrial fibrillation? Europace. 2022 Mar 2;24(3):355-356. doi: 10.1093/europace/euab225. PMID: 34499716.10.10. Xynogalos P, Rahm AK, Fried S, Chasan S, Scherer D, Seyler C, Katus HA, Frey N, Zitron E. Verapamil inhibits Kir2.3 channels by binding to the pore and interfering with PIP2 binding. Naunyn Schmiedebergs Arch Pharmacol. 2023 Apr;396(4):659-667. doi: 10.1007/s00210-022-02342-z. Epub 2022 Nov 29. PMID: 36445385; PMCID: PMC10042922.11.11. Shen R, Zuo D, Chen K, Yin Y, Tang K, Hou S, Han B, Xu Y, Liu Z, Chen H. K2P1 leak cation channels contribute to ventricular ectopic beats and sudden death under hypokalemia. FASEB J. 2022 Aug;36(8):e22455. doi: 10.1096/fj.202200707R. PMID: 35899468.12.12. Shattock, M.J.; Ottolia, M.; Bers, D.M.; Blaustein, M.P.; Boguslavskyi, A.; Bossuyt, J.; Bridge, J.H.; Chen-Izu, Y.; Clancy, C.E.; Edwards, A.; et al. Na+/Ca2+ exchange and Na+/K+-ATPase in the heart. J. Physiol. 2015, 593, 1361–1382.