Acute amiodarone promotes drift and early termination of spiral wave re-entry

Harumichi Nakagawa, Haruo Honjo, Yuko S. Ishiguro, Masatoshi Yamazaki, Yusuke Okuno, Masahide Harada, Hiroki Takanari, Ichiro Sakuma, Kaichiro Kamiya, Itsuo Kodama

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Intravenous application of amiodarone is commonly used in the treatment of life-threatening arrhythmias, but the underlying mechanism is not fully understood. The purpose of the present study is to investigate the acute effects of amiodarone on spiral wave (SW) re-entry, the primary organization machinery of ventricular tachycardia/fibrillation (VT/VF), in comparison with lidocaine. A two-dimensional ventricular myocardial layer was obtained from 24 Langendorff-perfused rabbit hearts, and epicardial excitations were analyzed by high-resolution optical mapping. During basic stimulation, amiodarone (5 μM) caused prolongation of action potential duration (APD) by 5.6%-9.1%, whereas lidocaine (15 μM) caused APD shortening by 5.0%-6.4%. Amiodarone and lidocaine reduced conduction velocity similarly. Ventricular tachycardias induced by DC stimulation in the presence of amiodarone were of shorter duration (sustained-VTs >30 s/total VTs: 2/58, amiodarone vs 13/52, control), whereas those with lidocaine were of longer duration (22/73, lidocaine vs 14/58, control). Amiodarone caused prolongation of VT cycle length and destabilization of SW re-entry, which is characterized by marked prolongation of functional block lines, frequent wavefront-tail interactions near the rotation center, and considerable drift, leading to its early annihilation via collision with anatomical boundaries. Spiral wave re-entry in the presence of lidocaine was more stabilized than in control. In the anisotropic ventricular myocardium, amiodarone destabilizes SW re-entry facilitating its early termination. Lidocaine, in contrast, stabilizes SW re-entry resulting in its persistence.

Original languageEnglish
Pages (from-to)338-347
Number of pages10
JournalHeart and Vessels
Volume25
Issue number4
DOIs
Publication statusPublished - 01-07-2010
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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