7.Chinese consensus on the use of antiarrhythmic drugs for rhythm control in atrial fibrillation.
Yi Hong SUN ; Nian LIU ; Yu Mei XUE ; Chang Sheng MA ; Shu Lin WU
Chinese Journal of Internal Medicine 2023;62(4):343-355
Rhythm control is crucial part of comprehensive management of atrial fibrillation (AF). Rhythm control can reduce the burden of AF effectively, reduce symptoms, and improve the prognosis in early AF. Antiarrhythmic drugs (AADs) are the first-line treatment for rhythm-control strategies. This consensus focuses on the principle of rhythm control in AF, the characteristics of AADs, and the medication recommendations for patients in different populations suffering from AF. Hence, this consensus aims to support clinical decision-making for AF therapy.
Humans
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Anti-Arrhythmia Agents/therapeutic use*
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Atrial Fibrillation/drug therapy*
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Consensus
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China
8.Ibutilide decreases defibrillation threshold by the reduction of activation pattern complexity during ventricular fibrillation in canine hearts.
Qi JIN ; Jian ZHOU ; Ning ZHANG ; Chang-Jian LIN ; Yang PANG ; Gang GU ; Wei-Feng SHEN ; Li-Qun WU
Chinese Medical Journal 2012;125(15):2701-2707
BACKGROUNDIbutilide has been commonly used for pharmacologic cardioversion of atrial fibrillation and flutter in clinical settings. The objective of this study was to investigate the effects of ibutilide on the defibrillation threshold (DFT), restitution properties, dispersion of refractoriness and activation patterns during ventricular fibrillation (VF).
METHODSIbutilide was administrated intravenously in six open-chest beagles. Before and after the drug administration, 20-second episodes of VF were electrically induced and recorded with a 10×10 unipolar electrode plaque sutured on the lateral epicardium of the left ventricle. DFT and VF activation patterns, including type of epicardial activation maps, VF cycle length (VF-CL), conduction velocity, wavelength (WL) and reentry incidence, were measured. Restitution properties and dispersion of refractoriness were estimated from activation recovery intervals (ARI) during pacing.
RESULTSCompared to baseline, ibutilide markedly decreased the DFT by 31% ((491 ± 14) V vs. (337 ± 59) V, P < 0.01). The drug significantly reduced the maximal slope of the restitution curve (1.34 ± 0.08 vs. 0.76 ± 0.06, P < 0.01) and its epicardial dispersion (0.36 ± 0.09 vs. 0.21 ± 0.06, coefficient of variation, P = 0.03). The dispersion of refractoriness was enhanced at the pacing cycle length of 300 ms to 160 ms by ibutilide. The drug significantly increased the VF-CL ((96 ± 19) ms vs. (112 ± 20) ms, P < 0.01) and the WL ((41 ± 9) mm vs. (52 ± 14) mm, P = 0.02) during VF, and reduced the reentry incidence by 25% (0.08 ± 0.02 vs. 0.06 ± 0.02, P < 0.01). In the epicardial activation maps, ibutilide significantly reduced the percentage of more complex activation maps during VF.
CONCLUSIONSIntravenous ibutilide significantly decreased the DFT. It might be due to reduction of activation pattern complexity during VF.
Animals ; Anti-Arrhythmia Agents ; therapeutic use ; Dogs ; Pericardium ; drug effects ; Sulfonamides ; therapeutic use ; Ventricular Fibrillation ; drug therapy ; physiopathology
10.Anti-arrhythmic research situation and thinking of traditional Chinese medicine monomer.
China Journal of Chinese Materia Medica 2014;39(8):1544-1546
The basic physiological function of anti-arrhythmic drugs is affects myocardial cell membrane ion channels. Change the ion flow and affect cell electrophysiological properties, change the conduction velocity, eliminate retrace, inhibit autorhythmicity and trigger events, inhibit the occurrence of arrhythmia, but will trigger a new activities, new retrace, produce new arrhythmia. In recent years, with the improvement of the theoretical system of traditional Chinese medicine and the production of new research methods, Chinese medicine treatment of arrhythmia has a new development. This article summarized the recent decades of which Chinese medicine monomer anti-arrhythmic drugs that had been proved by the influence of monomer anti-arrhythmic drugs, lists the differents traditional Chinese medicinal materials which chemical composition and the effective of the anti-arrhythmic effects, shows the unique advantages of Chinese medicine in the aspect of anti-arrhythmic, and points out that the current Chinese medicine in anti-arrhythmic (monomer) existing problems and solutions.
Anti-Arrhythmia Agents
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therapeutic use
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Arrhythmias, Cardiac
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drug therapy
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Biomedical Research
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Drugs, Chinese Herbal
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therapeutic use
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Humans
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