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实验性抗心律失常药物替地沙米在两种犬类模型中对房颤的转复作用。

Conversion of atrial fibrillation by the experimental antiarrhythmic drug tedisamil in two canine models.

作者信息

Fischbach P S, Barrett T D, Goyal R, Tran B C, Syed Z A, Hennan J K, Lucchesi B R

机构信息

Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor 48109-0632, USA.

出版信息

J Cardiovasc Electrophysiol. 2001 Oct;12(10):1138-44. doi: 10.1046/j.1540-8167.2001.01138.x.

Abstract

INTRODUCTION

Tedisamil is an experimental bradycardic agent possessing action potential-prolonging effects. It has been proven effective in terminating ventricular arrhythmias in several animal models and atrial flutter in a conscious dog model. There are no reports to date evaluating tedisamil's efficacy in terminating atrial fibrillation (AF).

METHODS AND RESULTS

Two different canine models of AF were used. One group of dogs (n = 6) was subjected to 28 days of chronic fibrillatory pacing at 50 Hz using an implantable neural stimulator. Sustained AF was achieved in all dogs within 14 days of initiating pacing. A second set of dogs (n = 5) had AF induced via bilateral vagal stimulation. Tedisamil 1 mg/kg was 100% effective in terminating AF in both models. Cardioversion was associated with a statistically significant prolongation of the fibrillatory cycle length immediately before return to normal sinus rhythm in both models. A dose-response trial was performed in the vagal AF group as well as in a second group of three dogs that underwent chronic fibrillatory pacing. The efficacy of tedisamil was dose dependent, with limited efficacy at 0.1 and 0.3 mg/kg intravenously in both models. Tedisamil was able to prevent reinduction of sustained AF 30 minutes after administration of 1 mg/kg in the chronic pacing model in all dogs. Side effects included minor hypersalivation in most dogs receiving the 1 mg/kg dose. No ventricular ectopy or arrhythmias were observed.

CONCLUSION

Tedisamil is effective for conversion of sustained AF to normal sinus rhythm in two different models of AF.

摘要

引言

替地沙米是一种具有延长动作电位作用的实验性心动过缓药物。已证实在几种动物模型中它能有效终止室性心律失常,在清醒犬模型中能终止心房扑动。迄今为止,尚无评估替地沙米终止心房颤动(AF)疗效的报告。

方法与结果

使用了两种不同的犬AF模型。一组犬(n = 6)使用植入式神经刺激器以50 Hz进行28天的慢性颤动起搏。在起搏开始后的14天内,所有犬均实现了持续性AF。第二组犬(n = 5)通过双侧迷走神经刺激诱发AF。在两种模型中,1 mg/kg的替地沙米终止AF的有效率均为100%。在两种模型中,复律均与恢复正常窦性心律前颤动周期长度的统计学显著延长相关。在迷走神经介导的AF组以及另一组接受慢性颤动起搏的3只犬中进行了剂量反应试验。替地沙米的疗效呈剂量依赖性,在两种模型中,静脉注射0.1和0.3 mg/kg时疗效有限。在慢性起搏模型中,所有犬在给予1 mg/kg替地沙米30分钟后均能预防持续性AF的再次诱发。副作用包括大多数接受1 mg/kg剂量的犬出现轻微流涎。未观察到室性早搏或心律失常。

结论

在两种不同的AF模型中,替地沙米可有效将持续性AF转为正常窦性心律。

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