Mechanisms of termination of reentrant atrial arrhythmias by class I and class III antiarrhythmic agents

Circulation Research
W Spinelli, B F Hoffman

Abstract

We studied atrial flutter due to circus movement in chronically instrumented conscious dogs to identify the mechanism by which class I and class III antiarrhythmic drugs terminate reentrant excitation. We used a crossover experimental design administering five class I agents and one class III agent, by intravenous bolus followed by intravenous infusion. The class I agents other than lidocaine were almost uniformly effective in terminating the arrhythmia (disopyramide in six of seven dogs, propafenone in six of six, flecainide in seven of seven, and SC-40230 in seven of seven). Termination was preceded by a marked increase in cycle length (ranging from +78% with propafenone to +55% with disopyramide), but with the exception of disopyramide, class I agents did not significantly shorten the excitable gap. With disopyramide the gap decreased from 49 +/- 3% to 28 +/- 3% of the cycle length. With no class I agent did the wavelength of effective refractoriness increase to approach the cycle length of the arrhythmia. Lidocaine, used as a negative control, terminated the reentry in one dog with modest prolongation of the cycle length. Terminations with class I agents correlated with depression of conduction rather than prolongation of r...Continue Reading

References

Jul 1, 1979·Journal of Cardiovascular Pharmacology·A B HodessE N Moore
May 1, 1978·Clinical Pharmacokinetics·N L Benowitz, W Meister
May 1, 1978·The American Journal of Cardiology·R LazzaraB J Scherlag
Mar 1, 1987·The American Journal of Cardiology·I G CrozierL Levy
Jun 1, 1987·The American Journal of Cardiology·E BernsG V Naccarelli
Oct 15, 1987·Experientia·P F Cranefield
Oct 1, 1986·Journal of the American College of Cardiology·P L PagéA L Waldo
Jul 1, 1973·Circulation Research·M A AllessieF J Schopman
Jan 1, 1970·Journal of Pharmaceutical Sciences·J C Loo, S Riegelman
May 1, 1966·Circulation Research·M L WagnerB F Hoffman
Jan 1, 1984·Annual Review of Pharmacology and Toxicology·L M Hondeghem, B G Katzung
Jul 18, 1913·The Journal of Physiology·G R Mines

❮ Previous
Next ❯

Citations

Oct 1, 1992·Cardiovascular Drugs and Therapy·T J Campbell
Feb 17, 1993·Molecular and Cellular Biochemistry·W ZhenjiuK Hashimoto
May 11, 2005·Cardiovascular Drugs and Therapy·Jian-Ling SunPing Zhang
Apr 1, 1991·Journal of the American College of Cardiology·H J Wellens
Apr 1, 1996·Journal of the American College of Cardiology·G B GuoB S Stambler
Nov 14, 1997·The American Journal of Cardiology·M D Landers, M J Reiter
Jan 11, 2001·Journal of Pharmacological and Toxicological Methods·G S Friedrichs
May 1, 1995·British Journal of Pharmacology·R B ClarkW R Giles
Dec 1, 1992·Pacing and Clinical Electrophysiology : PACE·B OlshanskyR J Hariman
Apr 1, 1996·Journal of Cardiovascular Electrophysiology·A O Grant
Nov 4, 1995·Journal of Interventional Cardiology·P A Boyden
May 10, 2002·Circulation Journal : Official Journal of the Japanese Circulation Society·Hidehiko NagasawaHiroshi Inoue
Dec 22, 2004·Journal of Cardiovascular Electrophysiology·Joseph G Akar, David J Wilber
Sep 24, 2005·Pacing and Clinical Electrophysiology : PACE·Nikolaos FragakisGeorge Katsaris
Sep 28, 2007·Pacing and Clinical Electrophysiology : PACE·Norishige MoritaTeruo Takano
Aug 8, 2008·Pacing and Clinical Electrophysiology : PACE·Norishige MoritaKyoichi Mizuno
Apr 24, 2013·Pacing and Clinical Electrophysiology : PACE·Hiroshige YamabeHisao Ogawa
Oct 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·M D RodefeldB I Bromberg
Aug 20, 1992·The American Journal of Cardiology·B Lüderitz, M Manz
Nov 29, 2008·Progress in Biophysics and Molecular Biology·Stanley NattelLeif Carlsson
Aug 30, 2000·Pacing and Clinical Electrophysiology : PACE·B MensourT Kus
Jun 7, 2005·American Journal of Physiology. Heart and Circulatory Physiology·Zhilin Qu, James N Weiss
Oct 4, 2012·Physical Review. E, Statistical, Nonlinear, and Soft Matter Physics·Marcel Hörning
Feb 23, 2000·Journal of Cardiovascular Pharmacology and Therapeutics·B N Singh
Jun 22, 2019·Journal of Veterinary Internal Medicine·Kathy N WrightHolly M Irvin

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