This research was supported by a grant from the Citizens United for Research in Epilepsy (CURE) to SLB.

1. Materials to Construct
 <ol>
	<li>A jugular vein catheter is constructed from a piece (100 mm) of PE-50 polyethylene tubing, beveled at one end, and then filled with heparin saline (50 U heparin/mL saline).</li>
	<li>The ECG recording electrodes are constructed from two 100 mm lengths of insulated silver wire (30AWG). One end of both wires is stripped and soldered to a microconnector, and the insulation is twisted to form a third wire that is used as ground. Five-mm of insulation is stripped from the distal end of the wires and discarded.</li>
</ol>
2. Implanting Jugular Vein Catheter
<ol>
	<li>Anesthetize the animal by administration of Urethane, ip (1.2 g/kg).</li>
	<li>Routinely check (10 min intervals) depth of anesthesia by evaluating the pedal withdrawal response and/or eye reflexes. If needed, supplement anesthesia.</li>
	<li>After the animal is at the appropriate plane of anesthesia, shave the right side of the neck from the clavicle to the chin.</li>
	<li>Make a longitudinal incision (10-15 mm) in the skin above the carotid artery and open the incision.</li>
	<li>Using blunt dissection techniques, spread the underlying muscle to locate and isolate the right jugular vein.</li>
	<li>Place two pieces of surgical silk (#2) under the jugular vein, and position the sutures at the rostral and caudal most portions of the incision. Tie the rostral ligature to discontinue flow through the vein.</li>
	<li>Retract the caudal ligature to lift the vessel off the underlying tissue and make a small cut. Then insert the beveled end of the heparin-filled (50 U/ml saline) PE-50 polyethylene catheter (100 mm in length), and advance the tip approximately 8 mm to the level of the right atrium. </li>
	<li>In order to secure the catheter, tie the caudal ligature around both the vessel and catheter. Finally, close the wound with either wound clips or suture.</li>
	<li>During the implantation of the catheter, the exposed end is either clamped with a hemostat or plugged to prevent back flow of blood prior to attachment to an infusion pump.</li>
</ol>
3. Implanting CG Electrodes
<ol>
	<li>Place the animal on its back and shave the chest. </li>
	<li>For placement of the electrodes, make two longitudinal incisions (&asymp; 10 mm), one in the upper right and one in the lower left quadrants of the chest, and free the overlying skin to expose the thoracic muscles.</li>
	<li>Suture one of the exposed 5-mm tips of the silver-wire electrodes into the thoracic muscles in each of the exposed areas, and place the ground electrode subcutaneously.</li>
	<li>Close the incisions with wound clips and plug the microconnector into the recording device.</li>
	<li>Wrap the animal loosely in a towel to maintain body temperature during the procedure.</li>
</ol>
4. Recording ECG
<ol>
	<li>Recordings are made using a Powerlab Data Acquisition System and Macintosh computer or similar hardware/software (amplified, 50X; filtered, 1-1000 Hz). </li>
	<li>Following a 20-30 min equilibration period, record ECG for 20 min.</li>
</ol>
5. Inducing Ventricular Arrhythmias
<ol>
	<li>Attach the jugular vein catheter to a remote syringe placed in a programmable infusion pump.</li>
	<li>Initiate the aconitine infusion at a rate to deliver a constant dose of 5 ug/kg/min for 7 minutes. </li>
	<li>Following ventricular fibrillation or the end of the infusion period, euthanize the animal using an approved procedure. </li>
</ol>
6. Analysis of ECG 
<ol>
	<li>The QT interval represents the total duration of ventricular electrical activity. Fig. 1 shows a model ECG recording and the duration of the QT interval. Calculate the mean time between the initiation of the Q-wave and termination of the T-wave for all recorded heartbeats over a five-minute interval obtained during the 20 min recording period. </li>
	<li>To correct the QT interval for differences in heart rate (QTc), use Bazett&#x2019;s formula, QTc=QT/(RR)&frac12;, where RR is the mean interval between heartbeats. The RR interval is calculated as the duration between successive Q-waves obtained during the analyzed period.</li>
	<li>The QT dispersion (QTd) is calculated by subtracting the minimum QT from the maximum QT recorded for each animal.</li>
</ol>
7. Analysis of Heart Rate Variability
<ol><li>Software programs (i.e. LabChart 7, ADInstruments, Inc.) that analyze variability in the RR intervals obtained during the period of analysis are used for automated calculation of both temporal and/or spectral variance in heart rate. </li></ol>
8. Analysis of Susceptibility to Ventricular Arrhythmias
<ol><li>Calculate the latency from the initiation of aconitine infusion to the first premature ventricular contraction (PVC, Fig. 2, Panel 1), ventricular tachycardia (VT, Fig, 2, Panel 2) and ventricular fibrillation (VF, Fig. 2 Panel 3). </li></ol>
9. Representative Results
Fig. 3 illustrates one measure of HRV in the spectral domain (root mean squared of the standard deviation of the RR 
interval, RMSSD) in control rats and in animals that underwent SE one week prior to testing. This measure of HRV, which represents changes in the 
parasympathetic control of cardiac function 26, is significantly decreased in animals following status epilepticus. Fig. 4 shows that both 
corrected QT interval (QTc, Panel A) and QT dispersion (QTd, Panel B) are significantly increased two weeks following SE27. Taken together, these 
data predict that SE increases risk of ventricular arrhythmias. This prediction is confirmed by the findings that the periods of aconitine infusion 
necessary to induce the experimental arrhythmias (PVC, VT, VF) observed in these studies were significantly smaller in animals following SE (Fig. 5)27.
<img src="/files/ftp_upload/2726/2726fig1.jpg" alt="figure 1" /> Figure 1.Model ECG recording of a normal heartbeat showing P, QRS, and T waves. The QT interval is calculated as the time between the dashed lines.
<img src="/files/ftp_upload/2726/2726fig2.jpg" alt="figure 2" /> Figure 2. Panel 1) Premature ventricular contractions (PVCs) are isolated contractions of the ventricles (B) that occur between normal heartbeats (A). PVC recordings are characterized by the absence of P and T waves. 
Panel 2 Ventricular tachycardia (VT) is a series of multiple ventricular contractions (C) that occur with no intervening normal heartbeats (A).
Panel 3 Ventricular fibrillation (VF) is the lack of discernable rhythm and no association between QRS and P waves (D).
<img src="/files/ftp_upload/2726/2726fig3.jpg" alt="figure 3" /> Figure 3. The root mean squared of the standard deviation (RMSSD; msec) of the intervals between heartbeats observed in control rats and in animals undergoing status epilepticus (SE) 1 wk prior to testing. **p&lt;0.01 compared to Control.
<img src="/files/ftp_upload/2726/2726fig4.jpg" alt="figure 4" /> Figure 4. Mean corrected QT interval (Panel A) and QT dispersion (Panel B) calculated from ECG recordings obtained from control animals (Cont) and from rats undergoing status epilepticus (SE) two weeks prior to testing. *p&lt;0.05 compared to Cont. (Metcalf, et al., Am. J. Physiol. Heart and Circ, 2009, Am Physiol Soc, used with permission from 27).
<img src="/files/ftp_upload/2726/2726fig5.jpg" alt="figure 5" /> Figure 5. Latencies (sec) between the initiation of aconitine infusion and the 1st premature ventricular contraction (PVC), ventricular tachycardia (VT), and ventricular fibrillation (VF) in control animals (Cont) and rats undergoing status epilepticus (SE) two weeks prior to testing. *p&lt;0.05, **p&lt;0.01 compared to Cont. (Metcalf, et al., Am. J. Physiol. Heart and Circ, 2009, Am Physiol Soc, used with permission from 27).

<ol>
	<li>Chugh, S. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Determinants+of+prolonged+QT+interval+and+their+contribution+to+sudden+death+risk+in+coronary+artery+disease:+The+Oregon+sudden+unexpected+death+study.">Determinants of prolonged QT interval and their contribution to sudden death risk in coronary artery disease: The Oregon sudden unexpected death study.</a> Circulation. 119, 663-670 (2009).</li><li>Darbar, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sensitivity+and+specificity+of+QTc+dispersion+for+identification+of+risk+of+cardiac+death+in+patients+with+peripheral+vascular+disease.">Sensitivity and specificity of QTc dispersion for identification of risk of cardiac death in patients with peripheral vascular disease.</a> BMJ. 312, 874-878 (1996).</li><li>Bruyne, M. C. d. e. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=QTc+dispersion+predicts+cardiac+mortality+in+the+elderly:+The+Rotterdam+study.">QTc dispersion predicts cardiac mortality in the elderly: The Rotterdam study.</a> Circulation. 97, 467-472 (1998).</li><li>Malik, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heart+rate+variability:+standards+of+measurement,+physiological+interpretation,+and+clinical+use.">Heart rate variability: standards of measurement, physiological interpretation, and clinical use.</a> Circulation. 93, 1043-1065 (1996).</li><li>Grippo, A. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increased+susceptibility+to+ventricular+arrhythmias+in+a+rodent+model+of+experimental+depression.">Increased susceptibility to ventricular arrhythmias in a rodent model of experimental depression.</a> Am. J. Physiol. 286, H619-H626 (2004).</li><li>Li, M., Wang, J., Xie, H. H., Shen, F. M., Su, D. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+susceptibility+of+ventricular+arrhythmia+to+aconitine+in+conscious+hypertensive+rats.">The susceptibility of ventricular arrhythmia to aconitine in conscious hypertensive rats.</a> Acta. 28, 211-215 (2007).</li><li>Beig, M. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Voluntary+exercise+does+not+affect+stress-induced+tachycardia,+but+improves+resistance+to+cardiac+arrhythmias+in+rats.">Voluntary exercise does not affect stress-induced tachycardia, but improves resistance to cardiac arrhythmias in rats.</a> Clin. Exp. Pharm. Physiol. , (2010).</li><li>Hazari, M. S., Haykai-Coates, N., Winsett, D. W., Costa, D. L., Farraj, A. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+single+exposure+to+particulate+or+gaseous+ari+pollution+increases+the+risk+of+aconitine-induced+cardiac+arrhythmia+in+hypertensive+rats.">A single exposure to particulate or gaseous ari pollution increases the risk of aconitine-induced cardiac arrhythmia in hypertensive rats.</a> Toxicol. Sci. 112, 532-542 (2009).</li><li>Amran, M. S., Hashimoto, K., Homma, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+sodium-calcium+exchange+inhibitors,+KB-R7943+and+SEA0400,+on+aconitine-induced+arrhythmias+in+guinea+pigs+in+vivo,+in+vitro,+and+in+computer+simulation+studies.">Effects of sodium-calcium exchange inhibitors, KB-R7943 and SEA0400, on aconitine-induced arrhythmias in guinea pigs in vivo, in vitro, and in computer simulation studies.</a> J. Pharmacol. Exp. Ther. 310, 83-89 (2004).</li><li>Klekot, A. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Antiarrhythmic+activity+of+a+membrane-protecting+agent+Sal'magin+in+rats+with+aconitine-induced+arrhythmias.">Antiarrhythmic activity of a membrane-protecting agent Sal'magin in rats with aconitine-induced arrhythmias.</a> Bull. Exp. Biol. Med. 142, 209-211 (2006).</li><li>Lowenstein, D. H., Alldredge, B. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Status+Epilepticus.">Status Epilepticus.</a> New England J. Med. 338, 970-976 (1998).</li><li>Walker, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Status+epilepticus:+an+evidence+based+guide.">Status epilepticus: an evidence based guide.</a> BMJ. 331, 673-677 (2005).</li><li>Shorvon, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Status epilepticus: its clinical features and treatment in children and adults. , (1994).</li><li>Boggs, J. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hemodynamic+monitoring+prior+to+and+at+the+time+of+death+in+status+epilepticus.">Hemodynamic monitoring prior to and at the time of death in status epilepticus.</a> Epilepsy Res. 31, 199-209 (1998).</li><li>Walton, N. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systemic+effects+of+generalized+convulsive+status+epilepticus.">Systemic effects of generalized convulsive status epilepticus.</a> Epilepsia. 34, S54-S58 (1993).</li><li>Boggs, J. G., Painter, J. A., DeLorenzo, R. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+electrocardiographic+changes+in+status+epilepticus.">Analysis of electrocardiographic changes in status epilepticus.</a> Epilepsy Res. 14, 87-94 (1993).</li><li>Painter, J. A., Shiel, F. O., DeLorenzo, R. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiac+pathology+findings+in+status+epilepticus.">Cardiac pathology findings in status epilepticus.</a> Epilepsia. 34, 30-30 (1993).</li><li>Lathers, C. M., Schraeder, P. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+pharmacology:+drugs+as+a+benefit+and/or+risk+in+sudden+unexpected+death+in+epilepsy.">Clinical pharmacology: drugs as a benefit and/or risk in sudden unexpected death in epilepsy.</a> J. Clin. Pharmacol. 42, 123-126 (2002).</li><li>Dashieff, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sudden+unexpected+death+in+epilepsy:+a+series+from+an+epilepsy+surgery+program+and+specualtion+of+the+relationship+to+sudden+cardiac+death.">Sudden unexpected death in epilepsy: a series from an epilepsy surgery program and specualtion of the relationship to sudden cardiac death.</a> J. Clin. Neurophysiol. 8, 216-222 (1991).</li><li>Tigaran, P. -. C. o. d. r. e. a., Dalager-Pedersen, S., Baandrup, S., Dam, U., M, ., Vesterby-Charles, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sudden+unexpected+death+in+epilepsy:+is+death+by+seizures+a+cardiac+event.">Sudden unexpected death in epilepsy: is death by seizures a cardiac event.</a> Am. J. Forensic Med. Pathol. 26, 99-105 (2005).</li><li>Leung, H., Kwan, P., Elger, C. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Finding+the+missing+link+between+ictal+bradyarrhythmia,+ictal+asystole,+and+sudden+unexpected+death+in+epilepsy.">Finding the missing link between ictal bradyarrhythmia, ictal asystole, and sudden unexpected death in epilepsy.</a> Epilepsy and Behavior. 9, 19-30 (2006).</li><li>Nei, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=EEG+and+ECG+in+sudden+unexplained+death+in+epilepsy.">EEG and ECG in sudden unexplained death in epilepsy.</a> Epilepsia. 45, 338-345 (2004).</li><li>Dudek, F. E., Clark, S., Williams, P. A., Grabenstatter, H. L., Pitkanen, A., Schwartzkroin, P. A., Moshe, S. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Models of Seizures and Epilepsy. , 415-432 (2006).</li><li>Turski, W. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Limbic+seizures+produced+by+pilocarpine+in+rats:+behavioral+electroencephalographic,+and+neuropathological+study.">Limbic seizures produced by pilocarpine in rats: behavioral electroencephalographic, and neuropathological study.</a> Behav. Brain Res. 9, 315-335 (1989).</li><li>Kulkarni, S. K., George, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lithium-pilocarpine+neurotoxicity:+a+potential+model+of+status+epilepticus.">Lithium-pilocarpine neurotoxicity: a potential model of status epilepticus.</a> Methods Find. Exp. Clin. Pharamacol. 17, 551-567 (1995).</li><li>Stein, P. K., Bosner, M. S., Kleiger, R. E., Conger, B. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hart+rate+variability:+a+measure+of+cardiac+autonomic+tone.">Hart rate variability: a measure of cardiac autonomic tone.</a> Am. Heart J. 127, 1376-1381 (1994).</li><li>Metcalf, C. S., Poelzing, S., Little, J. G., Bealer, S. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Status+epilepticus+induces+cardiac+myofilament+damage+and+increased+susceptibility+to+arrhythmias+in+rat.">Status epilepticus induces cardiac myofilament damage and increased susceptibility to arrhythmias in rat.</a> Am. J. Physiol. 297, H2120-H2127 (2009).</li></ol>

We have nothing to disclose.

Two aspects of the described procedures are of critical importance. Firstly, the rate of aconitine administration to the 
heart must be equivalent across animals. This requires consistent placement of the jugular vein catheter tips relative to the heart, and careful 
adjustment of the infusion rate. The rate of aconitine delivery to the hearts must be equal in order to appropriately evaluate the onset of 
ventricular arrhythmias relative to altered susceptibility. If aconitine delivery varies, then the latency to arrhyt...

methods for ecg evaluation of indicators of cardiac risk, and susceptibility to aconitine-induced arrhythmias in rats following status epilepticus

Lethal cardiac arrhythmias contribute to mortality in a number of pathological conditions. Several parameters obtained from a 
non-invasive, easily obtained electrocardiogram (ECG) are established, well-validated prognostic indicators of cardiac risk in patients suffering 
from a number of cardiomyopathies. Increased heart rate, decreased heart rate variability (HRV), and increased duration and variability of cardiac 
ventricular electrical activity (QT interval) are all indicative of enhanced cardiac risk 1-4. In animal models, it is valuable to compare 
these ECG-derived variables and susceptibility to experimentally induced arrhythmias. Intravenous infusion of the arrhythmogenic agent aconitine has
 been widely used to evaluate susceptibility to arrhythmias in a range of experimental conditions, including animal models of depression 5 and 
 hypertension 6, following exercise 7 and exposure to air pollutants 8, as well as determination of the antiarrhythmic efficacy of pharmacological 
 agents 9,10. 
It should be noted that QT dispersion in humans is a measure of QT interval variation across the full set of leads from a 
standard 12-lead ECG. Consequently, the measure of QT dispersion from the 2-lead ECG in the rat described in this protocol is different than that 
calculated from human ECG records. This represents a limitation in the translation of the data obtained from rodents to human clinical medicine.
Status epilepticus (SE) is a single seizure or series of continuously recurring seizures lasting more than 30 min 
11,12 11,12, and results in mortality in 20% of cases 13. Many individuals survive the SE, but die within 30 days 14,15.
 The mechanism(s) of this delayed mortality is not fully understood. It has been suggested that lethal ventricular arrhythmias contribute to many of these 
 deaths 14-17. In addition to SE, patients experiencing spontaneously recurring seizures, i.e. epilepsy, are at risk of premature 
 sudden and unexpected death associated with epilepsy (SUDEP) 18. As with SE, the precise mechanisms mediating SUDEP are not known. 
 It has been proposed that ventricular abnormalities and resulting arrhythmias make a significant contribution 18-22.
 To investigate the mechanisms of seizure-related cardiac death, and the efficacy of cardioprotective therapies, it is 
 necessary to obtain both ECG-derived indicators of risk and evaluate susceptibility to cardiac arrhythmias in animal models of seizure disorders 
 23-25. Here we describe methods for implanting ECG electrodes in the Sprague-Dawley laboratory rat (Rattus norvegicus), following SE,
 collection and analysis of ECG recordings, and induction of arrhythmias during iv infusion of aconitine.
 These procedures can be used to directly determine the relationships between ECG-derived measures of cardiac electrical 
 activity and susceptibility to ventricular arrhythmias in rat models of seizure disorders, or any pathology associated with increased risk of sudden 
 cardiac death.

Watch this Scientific Journal Video about Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus at JoVE.com

Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus

Techniques for measurement of electrical activity of the heart by electrocardiogram (ECG), and analysis of cardiac risk factors and susceptibility to arrhythmias following status epilepticus (SE) in the rat are described.

Lethal cardiac arrhythmias contribute to mortality in a number of pathological conditions. Several parameters obtained from a 
non-invasive, easily ...

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17.6K Views.  University of Utah. Techniques for measurement of electrical activity of the heart by electrocardiogram (ECG), and analysis of cardiac risk factors and susceptibility to arrhythmias following status epilepticus (SE) in the rat are described. 

Video: Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus

Ascending Aortic Constriction in Rats for Creation of Pressure Overload Cardiac Hypertrophy Model

Ascending aortic constriction is the most common and successful surgical model for creating pressure overload induced cardiac hypertrophy and heart failure. Here, we describe a detailed surgical procedure for creating pressure overload and cardiac hypertrophy in rats by constriction of the ascending aorta using a small metallic clip. After anesthesia, the trachea is intubated by inserting a cannula through a half way incision made between two cartilage rings of trachea. Then a skin incision is made at the level of the second intercostal space on the left chest wall and muscle layers are cleared to locate the ascending portion of aorta. The ascending aorta is constricted to 50&#8211;60% of its original diameter by application of a small sized titanium clip. Following aortic constriction, the second and third ribs are approximated with prolene sutures. The tracheal cannula is removed once spontaneous breathing was re-established. The animal is allowed to recover on the heating pad by gradually lowering anesthesia. The intensity of pressure overload created by constriction of the ascending aorta is determined by recording the pressure gradient using trans-thoracic two dimensional Doppler-echocardiography. Overall this protocol is useful to study the remodeling events and contractile properties of the heart during the gradual onset and progression from compensated cardiac hypertrophy to heart failure stage.

We describe a stepwise procedure for creating pressure overload and left ventricular hypertrophy in Wistar rats by constriction of the ascending aorta using a small metallic clip. This model is extensively used for studying remodeling changes during cardiac hypertrophy and for identifying and evaluating strategies for regression of such changes.

Ascending aortic constriction is the most common and successful surgical model for creating pressure overload induced cardiac hypertrophy and heart ...

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

The kidney normally functions to maintain hemodynamic homeostasis and is a major site of damage caused by drug toxicity. Drug-induced nephrotoxicity is estimated to contribute to 19- 25% of all clinical cases of acute kidney injury (AKI) in critically ill patients. AKI detection has historically relied on metrics such as serum creatinine (sCr) or blood urea nitrogen (BUN) which are demonstrably inadequate in full assessment of nephrotoxicity in the early phase of renal dysfunction. Currently, there is no robust diagnostic method to accurately detect hemodynamic alteration in the early phase of AKI while such alterations might actually precede the rise in serum biomarker levels. Such early detection can help clinicians make an accurate diagnosis and help in in decision making for therapeutic strategy. Rats were treated with Cisplatin to induce AKI. Nephrotoxicity was assessed for six days using high-frequency sonography, sCr measurement and upon histopathology of kidney. Hemodynamic evaluation using 2D and Color-Doppler images were used to serially study nephrotoxicity in rats, using the sonography. Our data showed successful drug-induced kidney injury in adult rats by histological examination. Color-Doppler based sonographic assessment of AKI indicated that resistive-index (RI) and pulsatile-index (PI) were increased in the treatment group; and peak-systolic velocity (mm/s), end-diastolic velocity (mm/s) and velocity-time integral (VTI, mm) were decreased in renal arteries in the same group. Importantly, these hemodynamic changes evaluated by sonography preceded the rise of sCr levels. Sonography-based indices such as RI or PI can thus be useful predictive markers of declining renal function in rodents. From our sonography-based observations in the kidneys of rats that underwent AKI, we showed that these noninvasive hemodynamic measurements may consider as an accurate, sensitive and robust method in detecting early stage kidney dysfunction. This study also underscores the importance of ethical issues associated with animal use in research.

Early stage hemodynamic dysfunction is critical to the development of kidney disease. Yet, detection methodologies are limited. Recent advances in sonography provide a noninvasive, accurate option for early detection of kidney injury. This study outlines a step-by-step, sonographic methodology for detecting kidney dysfunction using a drug-induced nephrotoxicity rat model.

The kidney normally functions to maintain hemodynamic homeostasis and is a major site of damage caused by drug toxicity. Drug-induced nephrotoxicity is ...

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

We present the conventional cardiac magnetic resonance (CMR) protocol for evaluating a suspected thrombus and highlight emerging techniques.&#160;The appearance of a mass on certain magnetic resonance (MR) sequences can help differentiate a thrombus from competing diagnoses such as a tumor. T1 and T2 signal characteristics of a thrombus are related to the evolution of hemoglobin properties. A thrombus typically does not enhance following contrast administration, which also helps differentiation from a tumor. We also highlight the emerging role of T1 mapping in the evaluation of a thrombus, which can add another level of support in diagnosis. Prior to any CMR exam, patient screening and interviews are critical to ensure safety and to optimize patient comfort. Effective communication during the exam between the technologist and the patient promotes proper breath holding technique and higher quality images. Volumetric post processing and structured reporting are helpful to ensure that the radiologist answers the ordering services&#39; question and communicates these results effectively. Optimal pre-MR safety evaluation, CMR exam execution, and post exam processing and reporting allow for delivery of high quality radiological service in the evaluation of a suspected cardiac thrombus.

The goal of this article is to describe how cardiac magnetic resonance can be used for the evaluation and diagnosis of a suspected cardiac thrombus. The method presented will describe data acquisition as well as the pre-procedure and post-procedure protocol.

We present the conventional cardiac magnetic resonance (CMR) protocol for evaluating a suspected thrombus and highlight emerging techniques.&#160;The ...

Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats

The use of experimental animal models has become crucial in cardiovascular science. Most studies using rodent models are focused on two-dimensional imaging to study the cardiac anatomy of the left ventricle and M-mode echo to assess its dimensions. However, this could limit a comprehensive study. Herein, we describe a protocol that allows an assessment of the heart chamber size, left ventricular function (systolic and diastolic) and valvular function. A conventional medical ultrasound machine was used in this protocol and different echo views were obtained through left parasternal, apical and suprasternal windows. In the left parasternal window, the long and short axis were acquired to analyze left chamber dimensions, right ventricle and pulmonary artery dimensions, and mitral, pulmonary and aortic valve function. The apical window allows the measurement of heart chamber dimensions and evaluation of systolic and diastolic parameters. It also allows Doppler assessment with detection and quantification of heart valve disturbances (regurgitation or stenosis). Different segments and walls of the left ventricle are visualized throughout all views. Finally, the ascending aorta, aortic arch, and descending aorta can be imaged through the suprasternal window. A combination of ultrasound imaging, Doppler flow and tissue Doppler assessment have been obtained to study cardiac morphology and function. This represents an important contribution to improve the assessment of cardiac function in adult rats with impact for research using these animal models.

A non-invasive protocol for transthoracic echocardiography assessment of cardiac anatomy and function for adult rats is presented in the current study. The heart valves, all four cardiac chambers and the ascending aorta, aortic arch and descending aorta are studied in detail.

The use of experimental animal models has become crucial in cardiovascular science. Most studies using rodent models are focused on two-dimensional ...

Semi-Minimal Invasive Method to Induce Myocardial Infarction in Rats and the Assessment of Cardiac Function by an Isolated Working Heart System

Myocardial infarction (MI) remains the main contributor to morbidity and mortality worldwide. Therefore, research on this topic is mandatory. An easily and highly reproducible MI induction procedure is required to obtain further insight and better understanding of the underlying pathological changes. This procedure can also be used to evaluate the effects or potency of new and promising treatments (as drugs or interventions) in acute MI, subsequent remodeling and heart failure (HF). After intubation and pre-operative preparation of the animal, an anesthetic protocol with isoflurane was performed, and the surgical procedure was conducted&#160;quickly. Using a minimally invasive approach, the left anterior descending artery (LAD) was located and occluded by a ligature. The occlusion can be performed acutely for subsequent reperfusion (ischemia/reperfusion injury). Alternatively, the vessel can be ligated permanently to investigate the development of chronic MI, remodeling or HF. Despite common pitfalls, the drop-out rates are minimal. Various treatments such as remote ischemic conditioning can be examined for their cardioprotective potential pre-, peri- and post-operatively. The post-operative recovery was quick as the anesthesia was precisely controlled and the duration of the operation was short. Post-operative analgesia was administered for three days. The minimally invasive procedure reduces the risk of infection and inflammation. Furthermore, it facilitates rapid recovery. The &#8220;working heart&#8221; measurements were performed ex vivo and enabled precise control of preload, afterload and flow. This procedure requires specific equipment and training for adequate performance. This manuscript provides a detailed step-by-step introduction for conducting these measurements.

This article presents an efficient method to perform myocardial ischemia and subsequent chronic reperfusion in rats using a minimally invasive approach. In addition, left ventricular hemodynamic function of rats is assessed by echocardiography and isolated working heart methods.&#160;

Myocardial infarction (MI) remains the main contributor to morbidity and mortality worldwide. Therefore, research on this topic is mandatory. An easily ...

Analyzing Long-Term Electrocardiography Recordings to Detect Arrhythmias in Mice

Arrhythmias are common, affecting millions of patients worldwide. Current treatment strategies are associated with significant side effects and remain ineffective in many patients. To improve patient care, novel and innovative therapeutic concepts causally targeting arrhythmia mechanisms are needed. To study the complex pathophysiology of arrhythmias, suitable animal models are necessary, and mice have been proven to be ideal model species to evaluate the genetic impact on arrhythmias, to investigate fundamental molecular and cellular mechanisms, and to identify potential therapeutic targets.
Implantable telemetry devices are among the most powerful tools available to study electrophysiology in mice, allowing continuous ECG recording over a period of several months in freely moving, awake mice. However, due to the huge number of data points (&gt;1 million QRS complexes per day), analysis of telemetry data remains challenging. This article describes a step-by-step approach to analyze ECGs and to detect arrhythmias in long-term telemetry recordings using the software, Ponemah, with its analysis modules, ECG Pro and Data Insights, developed by Data Sciences International (DSI). To analyze basic ECG parameters, such as heart rate, P wave duration, PR interval, QRS interval, or QT duration, an automated attribute analysis was performed using Ponemah to identify P, Q, and T waves within individually adjusted windows around detected R waves. 
Results were then manually reviewed, allowing adjustment of individual annotations. The output from the attribute-based analysis and the pattern recognition analysis was then used by the Data Insights module to detect arrhythmias. This module allows an automatic screening for individually defined arrhythmias within the recording, followed by a manual review of suspected arrhythmia episodes. The article briefly discusses challenges in recording and detecting ECG signals, suggests strategies to improve data quality, and provides representative recordings of arrhythmias detected in mice using the approach described above.

Here we present a step-by-step protocol for a semiautomated approach to analyze murine long-term electrocardiography (ECG) data for basic ECG parameters and common arrhythmias. Data are obtained by implantable telemetry transmitters in living and awake mice and analyzed using Ponemah and its analysis modules.

Arrhythmias are common, affecting millions of patients worldwide. Current treatment strategies are associated with significant side effects and remain ...

Modified Heterotopic Abdominal Heart Transplantation and a Novel Aortic Regurgitation Model in Rats

Over the past 50 years, many researchers have reported heterotopic abdominal heart transplantation in mice and rats, with some variations in the surgical technique. Modifying the transplantation procedure to strengthen the myocardial protection could prolong the ischemia time while preserving the donor&#39;s cardiac function. This technique&#39;s key points are as follows: transecting the donor&#39;s abdominal aorta before harvesting to unload the donor&#39;s heart; perfusing the donor&#39;s coronary arteries with a cold cardioplegic solution; and topical cooling of the donor&#39;s heart during the anastomosis procedure. Consequently, since this procedure prolongs the acceptable ischemia time, beginners can easily perform it and achieve a high success rate.
Moreover, a new aortic regurgitation (AR) model was established in this work using a technique different from the existing one,&#160;which is created by inserting a catheter from the right carotid artery and puncturing the native aortic valve under continuous echocardiographic guidance. A heterotopic abdominal heart transplantation was performed using the novel AR model. In the protocol, after the donor&#39;s heart is harvested, a stiff guidewire is inserted into the donor&#39;s brachiocephalic artery and advanced toward the aortic root. The aortic valve is punctured by pushing the guidewire further even after the resistance is felt, thus inducing AR. It is easier to damage the aortic valve using this method than with the procedure described in the conventional AR model. Additionally, this novel AR model does not contribute to the recipient&#39;s circulation; therefore, this method is expected to produce a more severe AR model than the conventional procedure.

This study demonstrates a reproducible heterotopic abdominal heart transplantation technique in rats that beginners can learn and perform. Additionally, a novel aortic regurgitation model in rats is generated by performing heterotopic abdominal heart transplantation and damaging the donor's aortic valve using a guidewire after harvesting.

Over the past 50 years, many researchers have reported heterotopic abdominal heart transplantation in mice and rats, with some variations in the surgical ...

Standardized Tuina Manipulation for Knee Osteoarthritis in Rats

Tuina Manipulation to Reduce Inflammation and Cartilage Loss in Knee Osteoarthritis Rats

Clinical trials suggest that Tuina manipulation is effective in treating knee osteoarthritis (KOA), while further studies are required to discover its mechanism. Therefore, the manipulation of animal models of knee osteoarthritis is critical. This protocol provides a standard process for Tuina manipulation on KOA rats and a preliminary exploration of the mechanism of Tuina for KOA. The press and kneading manipulation method (a kind of Tuina manipulation that refers to pressing and kneading the specific area of the body surface) is applied on 5 acupoints around the knee joint of rats. The force and frequency of the manipulation were standardized by finger pressure recordings, and the position of the rat during manipulation is described in detail in the protocol. The effect of manipulation can be measured by pain behavior tests and microscopic findings in synovial and cartilage. KOA rats showed significant improvement in pain behavior. The synovial tissue inflammatory infiltration was reduced in the Tuina group, and the expression of tumor necrosis factor (TNF)-&#945; was significantly lower. Compared to the control group, chondrocyte apoptosis was less in the Tuina group. This study provides a standardized protocol for Tuina manipulation on KOA rats and preliminary proof that the therapeutic effects of Tuina may be related to reducing synovial inflammation and delayed chondrocyte apoptosis.

Author Spotlight: Understanding the Mechanism of Tuina Manipulation in Rats 

We present a protocol for Tuina manipulation performed on plaster-immobilized-induced knee osteoarthritis rats. Based on the preliminary results, it suggested that the efficacy of the method relied on the reduction of inflammation and cartilage loss.

Clinical trials suggest that Tuina manipulation is effective in treating knee osteoarthritis (KOA), while further studies are required to discover its ...

Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test

Ischemic heart disease (IHD) represents a group of clinical syndromes characterized by myocardial ischemia, leading to an impairment in the myocardial blood supply and compromised perfusion. Several clinical variables assessed through a stress test, such as oxygen uptake (VO2) and heart rate oxygen pulse (HR/O2), have been attributed as cardiopulmonary prognostic factors in patients with IHD. However, other factors like hydration status (HS), potentially affecting the cardiopulmonary response, have been barely addressed. Unbalanced HS has a short-term effect on plasma volume and the sympathetic nervous system, which impacts blood volume, and lowers VO2 and HR/O2. Recently, bioelectrical impedance analysis (BIA), a method based on the opposition of body tissues (including fluid volume) to a low electrical current, has been widely used to assess HS by obtaining two components: resistance (R) and reactance (Xc) and using prediction formulas. However, several limitations as chronic illness or abnormal fluid status, may affect the results. In this sense, alternative BIA methods, such as bioelectrical impedance vector analysis (BIVA), have become relevant. R and Xc (adjusted by height) result in a vector plotted on the R/Xc graph, which allows interpreting the HS as normal or abnormal according to the distance of the mean vector. This study aims to describe how to determine HS by BIVA using a single-frequency device and compare the results with the cardiopulmonary response in patients with IHD.

Hydration status imbalances can have a short-term effect on direct and indirect determinants of oxygen uptake and pulse, and morbidity and mortality prognostic factors in ischemic heart disease. This protocol describes the technique for assessment of hydration status through bioelectrical impedance vector analysis and cardiopulmonary response during exercise stress test.

Ischemic heart disease (IHD) represents a group of clinical syndromes characterized by myocardial ischemia, leading to an impairment in the myocardial ...

&lt;i&gt;Desmodium caudatum &lt;/i&gt; Decoction&#039;s Impact on Intestinal Microbiota of Rats

Effects of Desmodium caudatum on Gastrointestinal Hormones and Intestinal Flora in Rats with Gastritis

In order to preliminarily explore the effects of Desmodium caudatum on gastritis and intestinal flora in rats, a chronic gastritis rat model was established using the classic sodium salicylate method. Eighteen SPF rats were divided into three groups: the control group (Group C), the model group (Group M), and the treatment group (Group T). Pathological sections of the gastric wall were taken from rats in each group. Furthermore, the concentrations of gastrin and malondialdehyde in the serum of rats in each group were determined by ELISA. Additionally, the effects of D. caudatum on the intestinal flora of rats with gastritis were explored through a detailed comparison of gut bacterial communities in the three groups, employing Illumina-based 16S rRNA gene sequencing. The results indicated that D. caudatum decoction could reduce the malondialdehyde content and increase the gastrin content. Moreover, D. caudatum decoction was found to enhance the diversity and abundance of intestinal flora, exerting a positive impact on the treatment of gastritis by regulating and restoring the intestinal flora.

Author Spotlight: Exploring the Mysteries of Sichuan&#039;s Herbal Medicine in Chinese Medicine Research

The present protocol describes the method for analyzing intestinal flora using Illumina-based 16S rRNA gene sequencing and provides a framework for evaluating the effectiveness of herbal decoctions.