A. Shimizu et al., ELECTROPHYSIOLOGICAL EFFECTS OF A NEW CLASS-III ANTIARRHYTHMIC AGENT (E-4031) ON THE CONDUCTION AND REFRACTORINESS OF THE IN-VIVO HUMAN ATRIUM, Cardiovascular Research, 27(7), 1993, pp. 1333-1338
Objective: The aim was to test the efficacy of a new class III drug, E
-4031, on human atrial muscle in vivo. Methods: Electrophysiological m
easurements were performed in 10 patients, age 54(SD 11) years, before
and during the continuous infusion of E-4031 (0.15 mug.kg-1.min-1) wh
ich followed an initial dose of 9 mug-kg-1.5 min-1. Extrastimuli at 50
0 ms were delivered from the right atrial appendage, high lateral righ
t atrium, and low lateral right atrium. The effective refractory perio
d, repetitive atrial firing zone, and fragmented atrial activity zone
were assessed at three sites in the right atrium. The conduction delay
zone from the stimulus artefact to the distal electrode pair at the c
oronary sinus was also measured. Results: E-4031 caused a significant
increase in overall right atrial effective refractory period from 210(
SD 29) to 232(26) ms (p<0.001, n=30 sites). There were significant dec
reases in the incidence of repetitive atrial firing (67% to 37%: p<0.0
05), in the repetitive atrial firing zone [23(20) to 11(22) ms: p<0.01
], and in the fragmented atrial activity zone [15(22) to 3(8) ms: p<0.
005], but no significant change in the conduction delay zone. However,
E-4031 significantly prolonged the longest coupling interval that eli
cited conduction delay, from 249(31) ms to 267(28) ms (p<0.01). E-4031
had no effect on the conduction time except at coupling intervals clo
se to the atrial effective refractory period. Conclusion: These result
s suggest that E-4031 has a potential effect in the treatment of human
paroxysmal atrial fibrillation.