Interactions between antiarrhythmic drugs and cardiac memory
Key result
Quinidine and E4031, but not lidocaine, prolonged repolarization and ERP and suppressed the evolution of cardiac memory in paced dogs (P<0.05 for pacing alone).
Why the study?
Do antiarrhythmic drugs alter the expression of cardiac memory, and does cardiac memory modulate the effects of these drugs in a canine model?
Population
Conscious, chronically-instrumented dogs
Comparison
Quinidine, lidocaine or E4031 administered… vs Pacing alone
Design
Preclinical, random order
Follow-up
2 hours (protocol 1) or 21 days (protocol 2)
Authors
Discussion
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Member takes
Implication
Hypothesis-generating in canine models; leaves open translation to human antiarrhythmic selection and safety.
Structured PICO
Do antiarrhythmic drugs alter the expression of cardiac memory, and does cardiac memory modulate the effects of these drugs in a canine model?
P
Population
Conscious, chronically-instrumented dogs paced to induce cardiac memory and treated with antiarrhythmic drugs.
I
Intervention
Quinidine, lidocaine or E4031 administered within therapeutic serum concentration ranges
C
Comparator
Pacing alone
O
Outcome
Evolution of cardiac memory (repolarization changes and effective refractory period [ERP])surrogate
Main Result
p-value: p=<0.05
Interactions between pacing-induced cardiac memory and antiarrhythmic drugs can significantly alter ventricular repolarization and refractoriness, potentially impacting drug efficacy and safety.
Cite This Study
Alexei N. Plotnikov (2001) studied Cardiac memory. Quinidine, lidocaine, and E4031 vs. Pacing alone was evaluated on Effective refractory period (ERP) and repolarization (p=<0.05). Quinidine and E4031, but not lidocaine, prolonged repolarization and ERP and suppressed the evolution of cardiac memory in paced dogs (P<0.05 for pacing alone).