Electrophysiological effects of flecainide and sotalol in the human atrium during persistent atrial fibrillation
| Autor: | Markus A. Engelen, Giinter Breithardt, Wilhelm Haverkamp, Michael R. Franz, Lars Eckardt, Kristina Wasmer, Paulus Kirchhof, Michael Ribbing |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Atrial action potential Time Factors Refractory Period Electrophysiological Physiology Atrial Appendage Electric Countershock Action Potentials Pilot Projects Pharmacology Sodium channel blocker Physiology (medical) Internal medicine Atrial Fibrillation medicine Potassium Channel Blockers Secondary Prevention Humans cardiovascular diseases Infusions Intravenous Flecainide Aged Atrium (architecture) business.industry Sotalol Atrial fibrillation Middle Aged medicine.disease Treatment Outcome cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents medicine.drug Sodium Channel Blockers |
| Zdroj: | Basic research in cardiology. 100(2) |
| ISSN: | 1435-1803 |
| Popis: | Atrial fibrillation (AF) shortens the atrial action potential and the atrial refractory period. These changes promote persistence of AF. Pharmacological prolongation of atrial action potential duration (APD) may therefore help to prevent recurrent AF. In addition to prolonging APD, sodium channel blockers may prevent AF by inducing post-repolarization refractoriness (PRR). We studied whether two antiarrhythmic drugs (sotalol, flecainide) prolong APD or induce PRR in the fibrillating human atrium.In 12 patients with persistent AF (11 male, 58 +/- 5 yrs, 27 +/- 7 months duration of AF), we recorded monophasic action potentials from the right atrial appendage and inferior right atrium at baseline and 15 minutes after intravenous administration of sotalol (1.5 mg/kg) or flecainide (2 mg/kg). APD and effective refractory periods (ERP) were determined.Both drugs prolonged APD90 during AF (flecainide from 109 +/- 7 ms to 137 +/- 10 ms, sotalol from 108 +/- 6 ms to 131 +/- 8 ms, both p0.05 vs. baseline). Sotalol prolonged ERP in parallel to APD (from 119 +/- 8 ms to 139 +/- 8 ms, p0.05). Flecainide induced PRR by prolonging ERP more than APD90 (from 134 +/- 9 ms to 197 +/- 28 ms, p0.05 vs. baseline and vs. sotalol).Flecainide and sotalol prolong the atrial action potential during atrial fibrillation in humans. In addition, flecainide induces atrial PRR. These electrophysiological effects may reduce AF recurrences and prevent their persistence. |
| Databáze: | OpenAIRE |
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