Flecainide Augments Muscle Sympathetic Nerve Activity in Humans.

Nagata, Yoshiki

doi:10.1253/circj.66.377

Cited by 6 publications

(2 citation statements)

References 37 publications

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“…Antiarrhythmic drugs were discontinued before the procedure and were restarted on the day after the procedure. Prior studies have shown that oral flecainide (47) and intravenous quinidine (38) raised MSNA in healthy individuals, whereas intravenous procainamide (58) decreased MSNA in healthy individuals. To our knowledge, there are no reports regarding the effects of stopping or restarting antiarrhythmic agents on MSNA in patients such as the those we studied.…”

Section: Study Limitationsmentioning

confidence: 99%

Sympathetic responses induced by radiofrequency catheter ablation of atrial fibrillation

Cui

González

Blaha

et al. 2019

American Journal of Physiology-Heart and Circulatory Physiology

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Radiofrequency catheter ablation (RFCA) is a frequently performed procedure in patients with atrial fibrillation. Prior studies have shown that the RFCA may directly stimulate vagal afferents during the procedure, whereas the vagal tone assessed by heart rate variability (HRV) is lowered weeks after the RFCA procedure. The effects of RFCA performed in the left atrium on sympathetic nerve activity have not been assessed. In the present study, we hypothesized that RFCA would lower muscle sympathetic nerve activity (MSNA) during ablation and would raise MSNA 1 day postablation. A total of 18 patients were studied. In protocol 1 ( n = 10), electrocardiogram, blood pressure, and MSNA in the peroneal nerve were recorded through the RFCA procedure performed in the electrophysiology laboratory. In protocol 2, eight patients were studied before the procedure and 1 day postablation. RFCA led to a decrease in MSNA immediately after the procedure (25.4 ± 3.2 to 17.2 ± 3.8 bursts/min, P < 0.05). Cardiac parasympathetic activity was determined using indexes of HRV and increased during the procedure. One day postablation, MSNA was above baseline values (21.3 ± 3.7 to 35.7 ± 2.6 bursts/min, P < 0.05). HRV indexes of cardiac parasympathetic activity fell, and the HRV index of sympathovagal balance was not significantly altered. The results show that RFCA raised cardiac parasympathetic activity and decreased MSNA during the procedure. One day postablation, MSNA rose and cardiac parasympathetic activity fell. In addition, RFCA evokes differentiated sympathetic responses directed to the heart and skeletal muscles. NEW & NOTEWORTHY The effects of radiofrequency catheter ablation performed in the left atrium on muscle sympathetic nerve activity (MSNA) have not been assessed. The results of this study show that radiofrequency catheter ablation raised cardiac parasympathetic activity and decreased MSNA during the procedure. One day postablation, MSNA rose and cardiac parasympathetic activity fell. We speculate that the partial autonomic afferent denervation induces these effects on autonomic activity.

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Section: Study Limitationsmentioning

confidence: 99%

Sympathetic responses induced by radiofrequency catheter ablation of atrial fibrillation

Cui

González

Blaha

et al. 2019

American Journal of Physiology-Heart and Circulatory Physiology

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“…Fifth, the atrial electophysiologcal properties are affected by sympathetic nerve activity and flecainide augments muscle sympathetic nerve activity. 30 We did not investigate the preventive effect of flecainide. However, the widening of the RAFZ, FAAZ and CDZ is closely related to spontaneously occurring episodes of AF.…”

Section: Study Limitationsmentioning

confidence: 99%

Effects of Flecainide on the Electrophysiological Properties of Atrial Vulnerability in Humans

Yoshiga

Shimizu

Yamagata

et al. 2003

Circ J

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The aims of this study were to evaluate the changes in the electrophysiological characteristics of the right atrium after the administration of flecainide and to clarify whether flecainide has a selective effect on human atrial tissue. Electrophysiological measurements were made in 38 patients, before and after intravenous administration of flecainide (2 mg/kg per 10 min). The effective refractory period of the right atrium (ERP-A), maximum conduction delay (Max.CD), repetitive atrial firing zone (RAFZ), fragmented atrial activity zone (FAAZ), and conduction delay zone (CDZ) were studied in the patients who were divided into 2 groups based on whether repetitive atrial firing (RAF) was induced in the baseline study. Flecainide significantly prolonged the ERP-A (202+/-22 to 238+/-33 ms, p<0.001) and shortened Max.CD (77+/-17 to 63+/-32 ms, p<0.05) in the patients with RAF, but not in those without RAF in the baseline study. After flecainide administration, there were significant reductions in the RAFZ (43+/-22 to 13+/-19 ms, p<0.0001), FAAZ (51+/-22 to 28+/-26 ms, p<0.001) and CDZ (70+/-21 to 48+/-30 ms, p<0.01) in the patients with RAF. However, atrial fibrillation (AF) was induced by stimulation after flecainide in 2 patients without RAF in the baseline study. There was a significant negative correlation between the ERP-A in the baseline study and the change in the ERP-A upon flecainide administration (r=0.45, p<0.01). Flecainide may preferentially activate the substrate for AF and RAF, but that action is mainly based on the electrophysiological characteristics found in the baseline study.

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Effect of pimobendan on cardiopulmonary baroreflex control of sympathetic nerve activity in healthy young men

Maruyama

Takamura

Takata

et al. 2005

Autonomic Neuroscience

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Flecainide Augments Muscle Sympathetic Nerve Activity in Humans.

Cited by 6 publications

References 37 publications

Sympathetic responses induced by radiofrequency catheter ablation of atrial fibrillation

Sympathetic responses induced by radiofrequency catheter ablation of atrial fibrillation

Effects of Flecainide on the Electrophysiological Properties of Atrial Vulnerability in Humans

Effect of pimobendan on cardiopulmonary baroreflex control of sympathetic nerve activity in healthy young men

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