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

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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.

元の言語English
ページ(範囲)338-347
ページ数10
ジャーナルHeart and Vessels
25
発行部数4
DOI
出版物ステータスPublished - 01-07-2010
外部発表Yes

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

これを引用

Nakagawa, H., Honjo, H., Ishiguro, Y. S., Yamazaki, M., Okuno, Y., Harada, M., Takanari, H., Sakuma, I., Kamiya, K., & Kodama, I. (2010). Acute amiodarone promotes drift and early termination of spiral wave re-entry. Heart and Vessels, 25(4), 338-347. https://doi.org/10.1007/s00380-009-1184-8