Comparison of the Effects of Na+ and K+ Channel Blockers on the Electrophysiological Properties of the Pulmonary Veins in Patients with Atrial Fibrillation
Introduction: We assessed the effects of pilsicainide, a pure Na+ channel blocker, and nifekalant, a pure rapid delayed rectifier potassium current (IKr) blocker, on the electrophysiological characteristics within the pulmonary vein (PV) and at the PV-left atrial (LA) junction. Methods and Results:...
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doaj-a6d5e08d65f84a7fb4f8ea4fa6b2122e2020-11-25T02:34:02ZengWileyJournal of Arrhythmia1880-42762010-01-0126425926610.1016/S1880-4276(10)80025-0Comparison of the Effects of Na+ and K+ Channel Blockers on the Electrophysiological Properties of the Pulmonary Veins in Patients with Atrial FibrillationTomoo Yasuda, MDKoichiro Kumagai, MDMasahiro Ogawa, MDHideko Nakashima, MDBo Zhang, PhDShin-ichiro Miura, MDKeijiro Saku, MDIntroduction: We assessed the effects of pilsicainide, a pure Na+ channel blocker, and nifekalant, a pure rapid delayed rectifier potassium current (IKr) blocker, on the electrophysiological characteristics within the pulmonary vein (PV) and at the PV-left atrial (LA) junction. Methods and Results: We used a basket catheter for PV mapping in 38 patients with paroxysmal atrial fibrillation (AF). Programmed stimulation was performed in the distal PV and PV-LA junction before and after the infusion of pilsicainide (1 mg/kg; n = 24) or nifekalant (0.3 mg/kg; n = 14). Both drugs significantly prolonged the effective refractory period (ERP) of the distal PV and PV-LA junction. Pilsicainide significantly decreased the ERP heterogeneity of the PV and PV-LA junction (36 ± 43 vs. 9 ± 60 ms, P < 0:05). In contrast, nifekalant significantly increased the ERP heterogeneity of the PV and PV-LA junction (from 38 ± 34 to 60 ± 46 ms, P < 0:01). Pilsicainide significantly prolonged the conduction time (S1-A1) from the distal PV to the PV-LA junction (from 42 ± 12 to 63 ± 26 ms, P < 0:001), whereas this did not change with nifekalant. Conclusions: In AF patients, pilsicainide has antiarrhythmic effects mainly on the distal PV by modifying the ERP and conduction properties. In contrast, nifekalant has antiarrhythmic effects mainly on the PV-LA junction by modifying the ERP.http://www.sciencedirect.com/science/article/pii/S1880427610800250NifekalantPulmonary veinAtrial fibrillationPilsicainideElectrophysiology |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tomoo Yasuda, MD Koichiro Kumagai, MD Masahiro Ogawa, MD Hideko Nakashima, MD Bo Zhang, PhD Shin-ichiro Miura, MD Keijiro Saku, MD |
spellingShingle |
Tomoo Yasuda, MD Koichiro Kumagai, MD Masahiro Ogawa, MD Hideko Nakashima, MD Bo Zhang, PhD Shin-ichiro Miura, MD Keijiro Saku, MD Comparison of the Effects of Na+ and K+ Channel Blockers on the Electrophysiological Properties of the Pulmonary Veins in Patients with Atrial Fibrillation Journal of Arrhythmia Nifekalant Pulmonary vein Atrial fibrillation Pilsicainide Electrophysiology |
author_facet |
Tomoo Yasuda, MD Koichiro Kumagai, MD Masahiro Ogawa, MD Hideko Nakashima, MD Bo Zhang, PhD Shin-ichiro Miura, MD Keijiro Saku, MD |
author_sort |
Tomoo Yasuda, MD |
title |
Comparison of the Effects of Na+ and K+ Channel Blockers on the Electrophysiological Properties of the Pulmonary Veins in Patients with Atrial Fibrillation |
title_short |
Comparison of the Effects of Na+ and K+ Channel Blockers on the Electrophysiological Properties of the Pulmonary Veins in Patients with Atrial Fibrillation |
title_full |
Comparison of the Effects of Na+ and K+ Channel Blockers on the Electrophysiological Properties of the Pulmonary Veins in Patients with Atrial Fibrillation |
title_fullStr |
Comparison of the Effects of Na+ and K+ Channel Blockers on the Electrophysiological Properties of the Pulmonary Veins in Patients with Atrial Fibrillation |
title_full_unstemmed |
Comparison of the Effects of Na+ and K+ Channel Blockers on the Electrophysiological Properties of the Pulmonary Veins in Patients with Atrial Fibrillation |
title_sort |
comparison of the effects of na+ and k+ channel blockers on the electrophysiological properties of the pulmonary veins in patients with atrial fibrillation |
publisher |
Wiley |
series |
Journal of Arrhythmia |
issn |
1880-4276 |
publishDate |
2010-01-01 |
description |
Introduction: We assessed the effects of pilsicainide, a pure Na+ channel blocker, and nifekalant, a pure rapid delayed rectifier potassium current (IKr) blocker, on the electrophysiological characteristics within the pulmonary vein (PV) and at the PV-left atrial (LA) junction.
Methods and Results: We used a basket catheter for PV mapping in 38 patients with paroxysmal atrial fibrillation (AF). Programmed stimulation was performed in the distal PV and PV-LA junction before and after the infusion of pilsicainide (1 mg/kg; n = 24) or nifekalant (0.3 mg/kg; n = 14). Both drugs significantly prolonged the effective refractory period (ERP) of the distal PV and PV-LA junction. Pilsicainide significantly decreased the ERP heterogeneity of the PV and PV-LA junction (36 ± 43 vs. 9 ± 60 ms, P < 0:05). In contrast, nifekalant significantly increased the ERP heterogeneity of the PV and PV-LA junction (from 38 ± 34 to 60 ± 46 ms, P < 0:01). Pilsicainide significantly prolonged the conduction time (S1-A1) from the distal PV to the PV-LA junction (from 42 ± 12 to 63 ± 26 ms, P < 0:001), whereas this did not change with nifekalant.
Conclusions: In AF patients, pilsicainide has antiarrhythmic effects mainly on the distal PV by modifying the ERP and conduction properties. In contrast, nifekalant has antiarrhythmic effects mainly on the PV-LA junction by modifying the ERP. |
topic |
Nifekalant Pulmonary vein Atrial fibrillation Pilsicainide Electrophysiology |
url |
http://www.sciencedirect.com/science/article/pii/S1880427610800250 |
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