Cardiac arrhythmias during
ischemia-reperfusion (I/R) are believed to be related to
free radicals generated in the heart especially during the period of reperfusion. The pineal secretory product,
melatonin, is known to be a potent
free radical scavenger and its pharmacological concentrations have been shown to reduce the I/R-induced arrhythmias in isolated rat hearts. However, the physiological role of
melatonin in the prevention of these arrhythmias is unknown. Rats were pinealectomized (Px) or
sham-operated (non-Px) (control) 2 months before the I/R studies. To produce arrhythmias, left main coronary artery was occluded for 7 min, followed by 7 min reperfusion, in anesthetized rats. The incidence of mortality resulted from irreversible
ventricular fibrillation (VF) was found significantly higher in the Px rats (63%) than in the control group (25%).
Melatonin administration (0.4 mg/kg, either before
ischemia or reperfusion) to Px rats significantly reduced the incidence of total (irreversible plus reversible) and irreversible VF and returned them to control values. On the other hand,
melatonin administration (0.4 and 4 mg/kg) to non-Px rats failed to attenuate the I/R arrhythmias, significantly. These results suggest that physiological
melatonin concentrations are important to reduce the I/R-induced VF and mortality, while pharmacological concentrations of
melatonin did not increase its beneficial effect on these arrhythmias. As
melatonin levels have been reported to decrease with age,
melatonin replacement
therapy may attenuate the incidence of
sudden cardiac death especially in older patients.