Procainamide and lidocaine produce dissimilar changes in ventricular repolarization and arrhythmogenicity in guinea‐pig

@article{Osadchii2014ProcainamideAL,
  title={Procainamide and lidocaine produce dissimilar changes in ventricular repolarization and arrhythmogenicity in guinea‐pig},
  author={Oleg E Osadchii},
  journal={Fundamental \& Clinical Pharmacology},
  year={2014},
  volume={28}
}
  • O. Osadchii
  • Published 1 August 2014
  • Medicine
  • Fundamental & Clinical Pharmacology
Procainamide is class Ia Na+ channel blocker that may prolong ventricular repolarization secondary to inhibition of IKr, the rapid component of the delayed rectifier K+ current. In contrast to selective INa blockers such as lidocaine, procainamide was shown to produce arrhythmogenic effects in the clinical setting. This study examined whether pro‐arrhythmic responses to procainamide may be accounted for by drug‐induced repolarization abnormalities including impaired electrical restitution… 
Aalborg Universitet Arrhythmogenic drugs can amplify spatial heterogeneities in the electrical restitution in perfused guinea-pig heart
Non-uniform shortening of the action potential duration (APD90) in different myocardial regions upon heart rate acceleration can set abnormal repolarization gradients and promote arrhythmia. This
Arrhythmogenic drugs can amplify spatial heterogeneities in the electrical restitution in perfused guinea-pig heart: An evidence from assessments of monophasic action potential durations and JT intervals
TLDR
Findings suggest that arrhythmic drug profiles are partly attributable to the accentuated regional heterogeneities in APD90 restitution, which can be indirectly determined through ECG assessments of the JTend vs. JTpeak dynamics at variable pacing rates.
Effects of antiarrhythmics and hypokalemia on the rate adaptation of cardiac repolarization
  • O. Osadchii
  • Medicine
    Scandinavian cardiovascular journal : SCJ
  • 2018
TLDR
The rate adaptation of ventricular repolarization is delayed by arrhythmogenic interventions, such as quinidine, procainamide, and hypokalemia, but not changed by lidocaine, a clinically safe antiarrhythmic agent.
Effects of Na+ channel blockers on the restitution of refractory period, conduction time, and excitation wavelength in perfused guinea-pig heart
TLDR
It is suggested that the slope of the EW restitution is an important electrophysiological determinant which can discriminate INa blockers with proarrhythmic and antiarrhythmic profile.
Aalborg Universitet Effects of Na + channel blockers on the restitution of refractory period , conduction time , and excitation wavelength in perfused guinea-pig heart
Na channel blockers flecainide and quinidine can increase propensity to ventricular tachyarrhythmia, whereas lidocaine and mexiletine are recognized as safe antiarrhythmics. Clinically, ventricular
Role of abnormal repolarization in the mechanism of cardiac arrhythmia
TLDR
The electrical activity of ventricular myocytes in normal conditions and cardiac disease is outlined, classical electrophysiological mechanisms of cardiac arrhythmia are described, and an update is provided on repolarization‐related surrogates currently used to assess arrhythmmic propensity.
Assessments of the QT/QRS restitution in perfused guinea-pig heart can discriminate safe and arrhythmogenic drugs.
  • O. Osadchii
  • Medicine
    Journal of pharmacological and toxicological methods
  • 2017
Effects of the venom of the spider Ornithoctonus hainana on neonatal rat ventricular myocytes cellular and ionic electrophysiology.
Ibutilide for the control of refractory ventricular tachycardia and ventricular fibrillation in patients with myocardial ischemia and hemodynamic instability
TLDR
The purpose of this study was to report the effect of intravenous ibutilide in patients with a VT and/or VF storm in the presence of incomplete revascularization requiring hemodynamic support.
...
1
2
...

References

SHOWING 1-10 OF 64 REFERENCES
Dofetilide Promotes Repolarization Abnormalities in Perfused Guinea-pig Heart
  • O. Osadchii
  • Medicine
    Cardiovascular Drugs and Therapy
  • 2012
TLDR
Proarrhythmic potential of dofetilide in guinea-pig heart is attributed to steepened electrical restitution, increased transepicardial variability in electrical restitution kinetics, amplified transmural dispersion of refractoriness, increased critical interval for ventricular re-excitation, and triangulation of epicardial action potential.
Flecainide-Induced Proarrhythmia Is Attributed to Abnormal Changes in Repolarization and Refractoriness in Perfused Guinea-Pig Heart
  • O. Osadchii
  • Medicine
    Journal of cardiovascular pharmacology
  • 2012
TLDR
In nonischemic guinea-pig heart, flecainide-induced proarrhythmia may be partly attributed to abnormal spatial gradients in repolarization and refractoriness and impaired transepicardial activation-to-repolarization coupling.
Predictive value of electrical restitution in hypokalemia-induced ventricular arrhythmogenicity.
TLDR
The superiority of ERP restitution at predicting increased arrhythmogenicity in the hypokalemic myocardium is highlighted, whereas the lack of predictive value of APD(90) restitution is presumably related to different mode of changes in ventricular repolarization and refractoriness in a hypokAlemic setting, whereby APD (90) prolongation may be associated with shortened ERP.
Mechanisms of hypokalemia‐induced ventricular arrhythmogenicity
  • O. Osadchii
  • Chemistry, Medicine
    Fundamental & clinical pharmacology
  • 2010
TLDR
The interplay of triggering factors (early and delayed afterdepolarizations, oscillatory prepotentials in Purkinje fibers) and a favorable electrophysiological substrate (unidirectional conduction block, reduced excitation wavelength, increased critical interval for ventricular re‐excitation) may account for the mechanism of life‐threatening tachyarrhythmias in hypokalemic patients.
Proarrhythmic Effects of Procainamide and Tocainide in a Canine Infarction Model
TLDR
There was no apparent correlation of QRS, JTc, and right ventricular ERP after drugs and proarrhythmia due to procainamide or tocainide, and there was no significant difference in the size of MI between dogs with one or more proARRhythmic response to either drug and dogs that had no proarrHythmia.
IKr vs. IKs blockade and arrhythmogenicity in normoxic rabbit Purkinje fibers: does it really make a difference?
TLDR
In normoxic rabbit Purkinje fibers, IKs blockade was neutral, whereas IKr blockade was pro‐arrhythmic, which may make a difference worth exploration in more complex models.
Postrepolarization refractoriness versus conduction slowing caused by class I antiarrhythmic drugs: antiarrhythmic and proarrhythmic effects.
TLDR
Drug-induced PRR protects against VF induction, probably by use-dependent conduction slowing and wavelength shortening, and monomorphic VT was induced with propafenone in 57% of burst stimulations.
Na+ channel distribution and electrophysiological heterogeneities in guinea pig ventricular wall.
TLDR
Higher Na(+) channel expression levels may contribute to greater excitability, steeper electrical restitution slopes and faster restitution kinetics, and greater susceptibility to stimulation-evoked tachyarrhythmias at endocardium than epicardium in the guinea pig heart.
Activation-repolarization coupling in the normal swine endocardium.
TLDR
The spatial distribution of repolarization is dependent on the activation pattern, and the tight coupling of the action potential duration to the activation process may serve as an important antiarrhythmic mechanism present in normal myocardium.
...
1
2
3
4
5
...