Key result
Epicardial delivery of an amiodarone-containing hydrogel significantly reduced the duration of sustained AF at 21 and 28 days in a pig model compared with systemic controls.
Why the study?
Does epicardial delivery of amiodarone-containing hydrogel reduce atrial fibrillation duration and inducibility in animal models?
Does epicardial delivery of amiodarone-containing hydrogel reduce atrial fibrillation duration and inducibility in animal models?
Minimally invasive epicardial delivery of amiodarone via hydrogel effectively reduces atrial fibrillation while minimizing systemic off-target toxicity in preclinical models.
Caution against clinical use from pig data alone; extends preclinical evidence for epicardial amiodarone hydrogel in AF.
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Although treatment options for AF exist, many patients cannot be maintained in normal sinus rhythm. Amiodarone is an effective medication for AF but has limited clinical utility because of off-target tissue toxicity. METHODS: Here, we use a pig model of AF to test the efficacy of an amiodarone-containing polyethylene glycol-based hydrogel. The gel is placed directly on the atrial epicardium through the pericardial space in a minimally invasive procedure using a specially designed catheter. RESULTS: Implantation of amiodarone-containing gel significantly reduced the duration of sustained AF at 21 and 28 days; inducibility of AF was reduced 14 and 21 days post-delivery. Off-target organ drug levels in the liver, lungs, thyroid, and fat were significantly reduced in animals treated with epicardial amiodarone gel compared with systemic controls in small-animal distribution studies. CONCLUSIONS: The pericardium is an underutilized therapeutic site and may be a new treatment strategy for AF and other cardiovascular diseases.
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García et al. (2018) studied Atrial fibrillation. Amiodarone-containing polyethylene glycol-based hydrogel vs. Systemic controls was evaluated on Duration of sustained AF and inducibility of AF. Epicardial delivery of an amiodarone-containing hydrogel significantly reduced the duration of sustained AF at 21 and 28 days in a pig model compared with systemic controls.
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