Comparison of vernakalant and ranolazine in atrial fibrillation.
J Cardiovasc Med (Hagerstown)
; 18(9): 663-668, 2017 Sep.
Article
em En
| MEDLINE
| ID: mdl-28692548
ABSTRACT
BACKGROUND:
Current guidelines recommend vernakalant for pharmacologic cardioversion of recent-onset atrial fibrillation. However, this drug is not established as chronic therapy. METHODS ANDRESULTS:
In total, 15 rabbit hearts were Langendorff-perfused. A burst pacing protocol-induced atrial fibrillation in 7 of 15 hearts at baseline (10 episodes). Subsequently, a combination of acetylcholine and isoproterenol (ACH/ISO) has been administered to increase occurrence of atrial fibrillation resulting in a reduction of atrial action potential duration (-25âms, Pâ<â0.05) as well as atrial effective refractory period (aERP; -36âms, Pâ<â0.05). Then, atrial fibrillation occurred in all 15 hearts (124 episodes). Additional treatment with vernakalant (10âµmol/l) induced a significant reduction of atrial fibrillation (6 of 15 hearts, 63 episodes). Infusion of vernakalant did not significantly alter atrial action potential duration (+8âms) but increased aERP (+16âms, Pâ<â0.05 as compared with ACH/ISO).Results were compared to 12 further rabbit hearts treated with ranolazine. Late sodium current inhibition by ranolazine also induced a significant increase of aERP. Here, atrial fibrillation was inducible after ranolazine infusion in 6 of 12 hearts (46 episodes). Of note, 10 of 12 hearts presented atrial fibrillation during sole treatment with ACH/ISO (174 episodes).CONCLUSION:
Vernakalant and ranolazine demonstrated a comparable antiarrhythmic efficacy. Therefore, vernakalant treatment may represent a potential therapeutic option to reduce atrial fibrillation recurrence.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pirrolidinas
/
Fibrilação Atrial
/
Fármacos Cardiovasculares
/
Ranolazina
/
Anisóis
Tipo de estudo:
Guideline
Idioma:
En
Revista:
J Cardiovasc Med (Hagerstown)
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Alemanha