Repetitive Evaluation of Fibrillation Cycle Length Predicts the Efficacy of Bepridil for Interruption of Long-Lasting Persistent Atrial Fibrillation

Aoyama, Yuya; Niwano, Shinichi; Niwano, Hiroe; Satoh, Akira; Kishihara, Jun; Ishikawa, Shoko; Murakami, Masami; Fukumoto, Kyoko; Ueno, K.; Izumi, Tohru

doi:10.1536/ihj.52.353

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…Similarly, 53 % of the 60 patients with long-lasting persistent AF were converted to SR by bepridil (100-200 mg/day for 8 weeks). Comparing these responders and non-responders revealed that the only difference was that the prolongation of fibrillation CL became significantly larger in responders suggesting that repetitive evaluation of fibrillation CL can be a feasible index to predict the efficacy of bepridil therapy [378]. Another study showed the same results (conversion in 50 % of the patients by 200 mg/day bepridil) and reached the same conclusion regarding responders [379].…”

Section: Human Data On Hemodynamic Effects Of Monatepilmentioning

confidence: 60%

Class IV Antiarrhythmic Agents: New Compounds Using an Old Strategy

Szentandrássy

Nagy²,

Hegyi³

et al. 2014

CPD

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Cardiac arrhythmias are a major cause of morbidity and mortality in the industrialized world. Among their treatment regimens one can find the calcium channel antagonists (CCAs), the class IV agents. In the cardiovascular system Land T-type calcium channels are found on vascular smooth muscle cells and cardiac myocytes with well defined physiological roles. Inhibition of calcium channels by CCAs has widely been used in clinical practice for several decades. Cardiovascular disorders are one of the many fields of medicine in which CCAs are used for various reasons and conditions. The three main indications of them are hypertension, angina and various cardiac arrhythmias. The most important classes of CCAs are dihydropyridines, phenylalkylamines and benzothiazepines but some newer compounds do not fall into any of these major classes. Dihydropyridines are not used in the antiarrhythmic therapy but are good vasodilators and antianginal agents. In contrast, phenylalkylamines and benzothiazepines exert cardiac actions in vivo and therefore these are one choice of antiarrhythmic drugs. This review focuses on phenylalkylamines, benzothiazepines and on new drugs with potential antiarrhythmic action in the heart as well as the mechanisms how calcium channels antagonism can lead to an antiarrhythmic action.

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Section: Human Data On Hemodynamic Effects Of Monatepilmentioning

confidence: 60%

Class IV Antiarrhythmic Agents: New Compounds Using an Old Strategy

Szentandrássy

Nagy²,

Hegyi³

et al. 2014

CPD

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“…7 We have previously reported that PAF tended be associated with longer FCL than persistent AF, but such a distinction still carries considerable error when using FCL as the only predicting index. 8 In the present study, we hypothesized that a combination of clinical parameters including FCL could distinguish PAF and non-PAF with acceptable sensitivity and specificity. The aim of this study was therefore to establish a scoring system for the distinction of PAF and non-PAF in patients with first documented AF.…”

mentioning

confidence: 94%

Novel Scoring System for Distinction Between Paroxysmal and Non-Paroxysmal Atrial Fibrillation

Oikawa

Niwano

Fukaya

et al. 2017

Circ J

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Background: Distinction of paroxysmal atrial fibrillation (PAF) from non-PAF is important in clinical practice, but this is often difficult at the time of first documented AF. Given that fibrillation cycle length (FCL) is longer in PAF than in non-PAF, the aim of this study was to compare various clinical parameters including FCL to establish a scoring system to distinguish PAF and non-PAF. Methods and Results:The subjects consisted of 382 consecutive patients with AF on digital ECG at the present institute between 2008 and 2011. They were divided into PAF and non-PAF groups according to the following clinical course. Propensity score matching yielded 88 matched patient pairs with similar mean age and gender between the 2 groups. FCL was evaluated using customized fibrillation wave analyzer with fast Fourier transform analysis. On multivariate analysis, higher HR, longer FCL, and smaller LAD were independent predictors of PAF. For the scoring, cut-offs for each parameter were determined according to highest sensitivity and specificity on the ROC curves, and 1 point assigned for each parameter. Using this scoring system, 2 points detected PAF with 64% sensitivity and 84% specificity. Conclusions:We propose a scoring system including FCL to distinguish PAF from non-PAF. Further studies are needed to validate the results.

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“…Measuring the ECG-derived atrial fibrillatory rate (AFR) is a noninvasive method and has been used to study the electrical remodeling that occurs during AF. [6][7][8] Furthermore, it has been proposed that AFR can be used to assess antiarrhythmic drug effects [9][10][11][12] and may predict the likelihood of druginduced cardioversion. 7 The alterations in atrial activity evident on the surface ECG following administration of a number of antiarrhythmic drugs (including dofetilide and ranolazine) have been studied, 9,10,[13][14][15] yet no such studies on the use of combination therapies are available.…”

Section: Introductionmentioning

confidence: 99%

Effects of dofetilide and ranolazine on atrial fibrillatory rate in a horse model of acutely induced atrial fibrillation

Carstensen

Hesselkilde

Haugaard

et al. 2019

Cardiovasc electrophysiol

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IntroductionThe atrial fibrillatory rate is a potential biomarker in the study of antiarrhythmic drug effects on atrial fibrillation (AF). The purpose of this study was to evaluate whether dose‐dependent changes in the atrial fibrillatory rate can be monitored on surface electrocardiography (ECG) following treatment with dofetilide, ranolazine, and a combination of the two in an acute model of AF in horses.Methods and ResultsEight horses were subjected to pacing‐induced AF on 4 separate days. Saline (control), dofetilide, ranolazine, or a combination of dofetilide and ranolazine was administered in four incremental doses. Atrial fibrillatory activity was extracted from surface ECGs using spatiotemporal QRST cancellation. The mean atrial fibrillatory rate before drug infusion was 297 ± 27 fpm. Dofetilide reduced the atrial fibrillatory rate following the infusion of low doses (0.89 µg/kg, P < 0.05) and within 5 minutes preceding cardioversion (P < 0.05). Cardioversion with ranolazine was preceded by a reduction in the atrial fibrillatory rate in the last minute (P < 0.05). The combination of drugs reduced the atrial fibrillatory rate in a similar manner to dofetilide used alone. A trend toward a lower atrial fibrillatory rate before drug infusion was found among horses cardioverting on low doses of the drugs.ConclusionThe atrial fibrillatory rate derived from surface ECGs showed a difference in the mode of action on AF between dofetilide and ranolazine. Dofetilide reduced the atrial fibrillatory rate, whereas ranolazine displayed a cardioverting mechanism that was distinct from a slowing of the fibrillatory process.

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Repetitive Evaluation of Fibrillation Cycle Length Predicts the Efficacy of Bepridil for Interruption of Long-Lasting Persistent Atrial Fibrillation

Cited by 6 publications

References 24 publications

Class IV Antiarrhythmic Agents: New Compounds Using an Old Strategy

Class IV Antiarrhythmic Agents: New Compounds Using an Old Strategy

Novel Scoring System for Distinction Between Paroxysmal and Non-Paroxysmal Atrial Fibrillation

Effects of dofetilide and ranolazine on atrial fibrillatory rate in a horse model of acutely induced atrial fibrillation

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