Pulmonary Delivery of Metoprolol Reduces Ventricular Rate During Atrial Fibrillation and Accelerates Conversion to Sinus Rhythm
| Autor: | Giovanna C. Pedreira, Sofia A. Medeiros, Fernanda Tessarolo Silva, Bruna Araujo Silva, Bruce D. Nearing, Luiz Belardinelli, Alexandre A. Marum, Richard L. Verrier, Alexandre L. Bortolotto |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Time Factors Sus scrofa 030204 cardiovascular system & hematology Ventricular Function Left 03 medical and health sciences Electrocardiography 0302 clinical medicine Heart Rate Internal medicine Heart rate Administration Inhalation Atrial Fibrillation medicine Animals Sinus rhythm Arterial Pressure PR interval Metoprolol Pharmacology medicine.diagnostic_test business.industry Atrial fibrillation medicine.disease Adrenergic beta-1 Receptor Antagonists Disease Models Animal 030104 developmental biology medicine.anatomical_structure Blood pressure Ventricle Cardiology Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents medicine.drug |
| Zdroj: | Journal of cardiovascular pharmacology. 75(2) |
| ISSN: | 1533-4023 |
| Popis: | Background Safe, effective pulmonary delivery of cardioactive agents in humans is under development. Objectives We examined whether intratracheal delivery of metoprolol can reduce ventricular rate during atrial fibrillation (AF) and accelerate conversion to sinus rhythm. Methods In 7 closed-chest, anesthetized Yorkshire pigs, AF was induced by intrapericardial infusion of acetylcholine (1 mL of 102.5-mM solution) followed by atrial burst pacing and was allowed to continue for 2 minutes before intratracheal instillation of sterile water or metoprolol (0.2-mg/kg bolus) using a catheter positioned at the bifurcation of the main bronchi. High-resolution electrograms were obtained from catheters fluoroscopically positioned in the right atrium and left ventricle. Results Rapid intratracheal instillation of metoprolol caused a 32-beat/min reduction in ventricular rate during AF (from 272 ± 13.7 to 240 ± 12.6 beats/min, P = 0.008) and a 2.3-minute reduction in AF duration (from 10.3 ± 2.0 to 8.0 ± 1.4 minutes, P = 0.018) compared with sterile water control. Conversion of AF to sinus rhythm was associated with rapid restoration (5-6 minutes) of heart rate and arterial blood pressure toward control values. Intratracheal metoprolol reduced AF dominant frequency by 31% (from 8.7 ± 0.9 to 6.0 ± 1.1 Hz, P = 0.04) compared with control and resulted in a trend toward a 5% increase in PR interval (from 174 ± 11.2 to 182 ± 11.4 ms, P = 0.07). Conclusions Intratracheal delivery of metoprolol effectively reduces ventricular rate during AF and accelerates conversion to normal sinus rhythm in a pig model of acetylcholine-induced AF. |
| Databáze: | OpenAIRE |
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