Differing Electrophysiological Effects of Various Antiarrhythmic Drugs on the Cardiac Chamber in Atrial Fibrillation.
- Author:
Su Young JANG
1
;
Jeong Gwan CHO
;
Hyung Ki JUNG
;
Won Ju KI
;
Kyoung Jin LEE
;
Jum Suk KO
;
Min Goo LEE
;
Keun Ho PARK
;
Doo Sun SIM
;
Nam Sik YOON
;
Hyun Ju YOON
;
Young Joon HONG
;
Hyung Wook PARK
;
Ju Han KIM
;
Youngkeun AHN
;
Myung Ho JEONG
;
Jong Chun PARK
;
Jung Chaee KANG
Author Information
1. The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. chojg@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Atrial fibrillation;
Amiodarone;
Electrophysiology
- MeSH:
Amiodarone;
Anti-Arrhythmia Agents;
Atrial Fibrillation;
Electrophysiology;
Flecainide;
Humans;
Propafenone
- From:Korean Journal of Medicine
2011;80(6):672-679
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Long-term antiarrhythmic drug therapy remains the principal approach for suppressing atrial fibrillation (AF) and maintaining sinus rhythm. In this study, we examined the differing electrophysiological effects of various antiarrhythmic drugs on the cardiac chamber and atrial selectivity in patients with AF. METHODS: We analyzed 134 patients (60.4 +/- 12.5 years, M:F = 1.14:1) who were administered a single antiarrhythmic agent for AF over 6 months: amiodarone (group A), flecainide (group F), or propafenone (group P). The P wave, QRS complex duration and dispersion, and QT interval and its dispersion were evaluated using a standard 12-lead electrocardiogram. RESULTS: There was no significant difference in age, gender ratio, or associated diseases among the three groups. In group A, Pmax, Pmin, P dispersion, QRSmax, QRSmin, and QRS dispersion were shorter than in groups F and P, whereas Pmax/QRSmax was the highest in group A (A = 1.2, F = 0.9, P = 1.0; p < 0.01). QTcmax and QTcmin were longer in group A, whereas QTc dispersion and the QT peak to end (A = 13.3 +/- 11.2, F = 30.7 +/- 24.9, P = 31.8 +/- 21.6; p < 0.01) were shorter in group A than in the other groups. CONCLUSIONS: Amiodarone had a weaker, but more selective, inhibitory effect on intra-atrial conduction, and inhibited ventricular repolarization more effectively and homogenously than flecainide or propafenone. These differing electrophysiological effects may contribute to the superior effectiveness and safety of amiodarone over flecainide or propafenone.
