CARDIAC RELEASE OF HISTAMINE AFTER VENTRICULAR-FIBRILLATION AND DEFIBRILLATION DURING INSERTION OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS (ICD)

Histamine has inotropic, chronotropic, arrhythmogenic, and vasoactive effects, and is released from the heart in ischaemia-reperfusion injur y. The effect of ventricular fibrillation (VF) and defibrillation (DEF ) on histamine release was investigated in 9 anaesthetized patients un dergoing transvenous implantation of ICD. Concomitant arterial and cor onary sinus (CS) blood samples were drawn before induction of VF (dura tion 20 seconds), immediately after, and 2 and 5 min after DEF (18-24 Joules). Basal 2.5 +/- 6 nmol/l, and did not histamine level in CS was 1.1 +/- 0.2 nmol/l before VF (p < 0.008 compared to arterial), and in creased to 2.5 +/- 0.6 nmol/l immediately after (p < 0.045 compared to basal), to 3 +/- 1.1 nmol/l 2 mill after (p < 0.45), and to 2.4 +/- 0 .8 nmol/l 5 mill after VF. In the basal state there was an uptake of h istamine across the coronary circulation. After VF/DEF the level of hi stamine increased in corollary venous blood, suggesting cardiac releas e of histamine.