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Volume 22
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10.3390/ijms22095003
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Review

The Defibrillation Conundrum: New Insights into the Mechanisms of Shock-Related Myocardial Injury Sustained from a Life-Saving Therapy

by
Nicolas Clementy
1,2,*,
Alexandre Bodin
1,
Arnaud Bisson
1,2,
Ana-Paula Teixeira-Gomes
3,
Sebastien Roger
2,
Denis Angoulvant
1,2,
Valérie Labas
3 and
Dominique Babuty
1,2
1
Service de Cardiologie, Hôpital Trousseau, Université de Tours, 37044 Tours, France
2
Transplantation, Immunologie et Inflammation T2I-EA 4245, Université de Tours, 37044 Tours, France
3
Plate-forme de Chirurgie et d’Imagerie pour la Recherche et l’Enseignement (CIRE), INRA, Université de Tours, CHU de Tours, 37380 Nouzilly, France
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2021, 22(9), 5003; https://doi.org/10.3390/ijms22095003
Submission received: 26 April 2021 / Revised: 3 May 2021 / Accepted: 5 May 2021 / Published: 8 May 2021
(This article belongs to the Special Issue Advances in Understanding of Cardiac Arrhythmias for Innovative Treatment)
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Abstract

Implantable cardiac defibrillators (ICDs) are recommended to prevent the risk of sudden cardiac death. However, shocks are associated with an increased mortality with a dose response effect, and a strategy of reducing electrical therapy burden improves the prognosis of implanted patients. We review the mechanisms of defibrillation and its consequences, including cell damage, metabolic remodeling, calcium metabolism anomalies, and inflammatory and pro-fibrotic remodeling. Electrical shocks do save lives, but also promote myocardial stunning, heart failure, and pro-arrhythmic effects as seen in electrical storms. Limiting unnecessary implantations and therapies and proposing new methods of defibrillation in the future are recommended.
Keywords: defibrillation; mechanism; injury; electrical; shock; proteomics defibrillation; mechanism; injury; electrical; shock; proteomics

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MDPI and ACS Style

Clementy, N.; Bodin, A.; Bisson, A.; Teixeira-Gomes, A.-P.; Roger, S.; Angoulvant, D.; Labas, V.; Babuty, D. The Defibrillation Conundrum: New Insights into the Mechanisms of Shock-Related Myocardial Injury Sustained from a Life-Saving Therapy. Int. J. Mol. Sci. 2021, 22, 5003. https://doi.org/10.3390/ijms22095003

AMA Style

Clementy N, Bodin A, Bisson A, Teixeira-Gomes A-P, Roger S, Angoulvant D, Labas V, Babuty D. The Defibrillation Conundrum: New Insights into the Mechanisms of Shock-Related Myocardial Injury Sustained from a Life-Saving Therapy. International Journal of Molecular Sciences. 2021; 22(9):5003. https://doi.org/10.3390/ijms22095003

Chicago/Turabian Style

Clementy, Nicolas, Alexandre Bodin, Arnaud Bisson, Ana-Paula Teixeira-Gomes, Sebastien Roger, Denis Angoulvant, Valérie Labas, and Dominique Babuty. 2021. "The Defibrillation Conundrum: New Insights into the Mechanisms of Shock-Related Myocardial Injury Sustained from a Life-Saving Therapy" International Journal of Molecular Sciences 22, no. 9: 5003. https://doi.org/10.3390/ijms22095003

APA Style

Clementy, N., Bodin, A., Bisson, A., Teixeira-Gomes, A.-P., Roger, S., Angoulvant, D., Labas, V., & Babuty, D. (2021). The Defibrillation Conundrum: New Insights into the Mechanisms of Shock-Related Myocardial Injury Sustained from a Life-Saving Therapy. International Journal of Molecular Sciences, 22(9), 5003. https://doi.org/10.3390/ijms22095003

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