[Structural and functional bases of the mechanisms of myocardial fibrillation in sudden cardiac death].

Analysis of current data indicates that one of the important and unsolved problems in the concept of sudden cardiac death is the question on the trigger mechanisms of the ventricular fibrillation which is the most frequent cause of heart failure in the sudden death of patients with coronary heart disease. It can be assumed that the spread, with the circulating blood, in the myocardial tissue of the arythmogenic substances formed in the hypoxic areas of the ischemized heart muscle or as an effect of catecholamines favour the fibrillation. Penetration of the arythmogenic substances into the circulation is due to the blood circulation remaining in the ischemic zone or the reperfusion of the ischemic tissue. Amphiphilic lysophosphoglycerides, cAMP, free fatty acids, lipid peroxidation products, some forms of prostaglandins may play a role of arythmogenic substances.