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Effects of the NA+ channel blocker pilsicainide on the electrophysiologic properties of pulmonary veins in patients with atrial fibrillation.
J Cardiovasc Electrophysiol. 2004 Dec; 15(12):1396-401.JC

Abstract

INTRODUCTION

Na+ channel blockers are used to treat atrial fibrillation (AF). However, the effects of Na+ channel blockers on the electrophysiologic properties of pulmonary veins (PVs) are not well characterized. The aim of the present study was to evaluate the effect of the pure Na+ channel blocker pilsicainide on the PVs.

METHODS AND RESULTS

PV mapping using a basket catheter was performed in 28 patients with paroxysmal AF. Twenty-eight PVs, including 20 left superior and 8 right superior PVs, were studied. Programmed stimulation was performed in the distal PV and PV-left atrial (LA) junction before and after infusion of pilsicainide (1 mg/kg). Pilsicainide significantly prolonged the effective refractory period (ERP) of the distal PV from 163 +/- 44 msec to 192 +/- 53 msec (P < 0.001), PV-LA junction from 227 +/- 48 msec to 235 +/- 52 msec (P < 0.05), and LA appendage from 225 +/- 55 msec to 245 +/- 48 msec (P < 0.05). Pilsicainide significantly prolonged the conduction time from the distal PV to PV-LA junction from 45 +/- 14 msec to 70 +/- 26 msec (P < 0.0001). In 3 of 5 patients who experienced AF termination with pilsicainide, PV-LA conduction block was observed just before AF termination.

CONCLUSIONS

Pilsicainide can modify ERP heterogeneity and conduction properties in the PV and at the PV-LA junction. Because the PV and PV-LA junction have important roles as substrates for AF maintenance, pilsicainide may terminate AF by pharmacologic PV isolation.

Authors+Show Affiliations

Kumagai K
Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan. kxk@fukuoka-u.ac.jp
Tojo H
No affiliation info available
Noguchi H
No affiliation info available
Yasuda T
No affiliation info available
Ogawa M
No affiliation info available
Nakashima H
No affiliation info available
Zhang B
No affiliation info available
Saku K
No affiliation info available

MeSH

Atrial FibrillationElectrophysiologic Techniques, CardiacFemaleHumansInfusions, IntravenousLidocaineMaleMiddle AgedPulmonary VeinsSodium Channel BlockersTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15610286

Citation

Kumagai, Koichiro, et al. "Effects of the NA+ Channel Blocker Pilsicainide On the Electrophysiologic Properties of Pulmonary Veins in Patients With Atrial Fibrillation." Journal of Cardiovascular Electrophysiology, vol. 15, no. 12, 2004, pp. 1396-401.
Kumagai K, Tojo H, Noguchi H, et al. Effects of the NA+ channel blocker pilsicainide on the electrophysiologic properties of pulmonary veins in patients with atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15(12):1396-401.
Kumagai, K., Tojo, H., Noguchi, H., Yasuda, T., Ogawa, M., Nakashima, H., Zhang, B., & Saku, K. (2004). Effects of the NA+ channel blocker pilsicainide on the electrophysiologic properties of pulmonary veins in patients with atrial fibrillation. Journal of Cardiovascular Electrophysiology, 15(12), 1396-401.
Kumagai K, et al. Effects of the NA+ Channel Blocker Pilsicainide On the Electrophysiologic Properties of Pulmonary Veins in Patients With Atrial Fibrillation. J Cardiovasc Electrophysiol. 2004;15(12):1396-401. PubMed PMID: 15610286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of the NA+ channel blocker pilsicainide on the electrophysiologic properties of pulmonary veins in patients with atrial fibrillation. AU - Kumagai,Koichiro, AU - Tojo,Hideaki, AU - Noguchi,Hiroo, AU - Yasuda,Tomoo, AU - Ogawa,Masahiro, AU - Nakashima,Hideko, AU - Zhang,Bo, AU - Saku,Keijiro, PY - 2004/12/22/pubmed PY - 2005/4/9/medline PY - 2004/12/22/entrez SP - 1396 EP - 401 JF - Journal of cardiovascular electrophysiology JO - J Cardiovasc Electrophysiol VL - 15 IS - 12 N2 - INTRODUCTION: Na+ channel blockers are used to treat atrial fibrillation (AF). However, the effects of Na+ channel blockers on the electrophysiologic properties of pulmonary veins (PVs) are not well characterized. The aim of the present study was to evaluate the effect of the pure Na+ channel blocker pilsicainide on the PVs. METHODS AND RESULTS: PV mapping using a basket catheter was performed in 28 patients with paroxysmal AF. Twenty-eight PVs, including 20 left superior and 8 right superior PVs, were studied. Programmed stimulation was performed in the distal PV and PV-left atrial (LA) junction before and after infusion of pilsicainide (1 mg/kg). Pilsicainide significantly prolonged the effective refractory period (ERP) of the distal PV from 163 +/- 44 msec to 192 +/- 53 msec (P < 0.001), PV-LA junction from 227 +/- 48 msec to 235 +/- 52 msec (P < 0.05), and LA appendage from 225 +/- 55 msec to 245 +/- 48 msec (P < 0.05). Pilsicainide significantly prolonged the conduction time from the distal PV to PV-LA junction from 45 +/- 14 msec to 70 +/- 26 msec (P < 0.0001). In 3 of 5 patients who experienced AF termination with pilsicainide, PV-LA conduction block was observed just before AF termination. CONCLUSIONS: Pilsicainide can modify ERP heterogeneity and conduction properties in the PV and at the PV-LA junction. Because the PV and PV-LA junction have important roles as substrates for AF maintenance, pilsicainide may terminate AF by pharmacologic PV isolation. SN - 1045-3873 UR - https://www.unboundmedicine.com/medline/citation/15610286/Effects_of_the_NA+_channel_blocker_pilsicainide_on_the_electrophysiologic_properties_of_pulmonary_veins_in_patients_with_atrial_fibrillation_ DB - PRIME DP - Unbound Medicine ER -