A chronic pig model for comprehensive longitudinal studies of ventricular arrhythmias after ischemia and reperfusion

Ventricular arrhythmias (VAs) after myocardial infarction (MI) remain the leading cause of sudden cardiac death and a significant challenge in clinical cardiology. Animal studies play an important role for advances in the field providing mechanistic insights. Pig models are especially important for translational and preclinical studies due to their similarity to human coronary anatomy and cardiac electrophysiology. We have established a model and protocol which allows comprehensive in vivo phenotyping as well as ex vivo characterization of the tissue level substrate for arrhythmias in longitudinal studies. The objective of this paper is to provide detailed practical descriptions of the procedures, contextualized by existing literature, with an aim to advance standardization and reproducibility of preclinical studies with pigs and appropriate adaptations of similar models in other studies. Such efforts will be key to translate fundamental insights to humans.