Copyright © 1993 by the European Society of Cardiology.
© 1993 The European Society of Cardiology
Cibenzoline transforms random re-entry into ordered re-entry in the atria
Cardiovascular Center, OLV Hospital Aalst, Belgium
*Arrhythmia Unit, Department of Cardiology, Hospital Clinic, University of Barcelona Spain
Received 2 December 1991; revised 11 May 1992; .
Correspondence: Pedro Brugada, MD, Cardiovascular, Center, OLV Hospital, Moorselbaan 164, 9300 Aalst, Belgium
Abstract
The goal of this study was to test the hypothesis that class 1 drugs modify the electrophysiological substrate of atrial fibrillation. The effects of a single intravenous dose (1.4±0.3mg. kg–1) of the new class 1 drug, cibenzoline, were studied in 20 patients with spontaneous (n = 11) or induced (n = 9) atrial fibrillation, during an electrophysiological study. In one additional patient with chronic atrial fibrillation, the effects of a single intravenous dose of 2mg. kg–1 of cibenzoline were studied intra-operativelv before undergoing a ‘corridor’ operation. High resolution epicardial mapping (248 channels) was used to reconstruct the atrial activation patterns before and after administration of the drug. In 18 out of 20 patients administration of cibenzoline resulted in conversion of atrial fibrillation into regular monomorphic atrial tachycardia. In these 18 patients, the mean atrial cycle length was prolonged from 147±34 ms during atrial fibrillation to 302±34 ms after cibenzoline (P <0.001). In eight out of the 18 patients, spontaneous (n = 3) or pacing induced (n = 5) conversion into sinus rhythm was observed after administration of the drug. In the patient undergoing the ‘corridor’ operation, epicardial mapping of both atria showed that the multiple wavelets present during atrial fibrillation fused in to a single broad wavefron circulating counterclockwise around the caval veins after cibenzoline.
In conclusion, cibenzoline transforms random re-entry into ordered re-entry in the atria. This effect seems related to the depression of conduction produced by the drug.
Key Words: Atrial fibrillation • anti-arrhythmic drug • cibenzoline • re-entry
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. Comtois, M. Sakabe, E. J. Vigmond, M. Munoz, A. Texier, A. Shiroshita-Takeshita, and S. Nattel Mechanisms of atrial fibrillation termination by rapidly unbinding Na+ channel blockers: insights from mathematical models and experimental correlates Am J Physiol Heart Circ Physiol, October 1, 2008; 295(4): H1489 - H1504. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Qu and J. N. Weiss Effects of Na+ and K+ channel blockade on vulnerability to and termination of fibrillation in simulated normal cardiac tissue Am J Physiol Heart Circ Physiol, October 1, 2005; 289(4): H1692 - H1701. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Kneller*, J. Kalifa*, R. Zou, A. V. Zaitsev, M. Warren, O. Berenfeld, E. J. Vigmond, L. J. Leon, S. Nattel, and J. Jalife Mechanisms of Atrial Fibrillation Termination by Pure Sodium Channel Blockade in an Ionically-Realistic Mathematical Model Circ. Res., March 18, 2005; 96(5): e35 - e47. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Shimizu and O. A. Centurion Electrophysiological properties of the human atrium in atrial fibrillation Cardiovasc Res, May 1, 2002; 54(2): 302 - 314. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Geelen and P. Brugada Hybrid theraphy for atrial fibrillation Eur. Heart J., April 1, 2000; 21(7): 509 - 510. [PDF]
|
|
|
|
|
|
R.J Schilling, A.H Kadish, N.S Peters, J Goldberger, and D.W. Davies Endocardial mapping of atrial fibrillation in the human right atrium using a non-contact catheter Eur. Heart J., April 1, 2000; 21(7): 550 - 564. [Abstract] [PDF]
|
|
|
|
|
|
A. Bollmann, K. Sonne, H.-D. Esperer, I. Toepffer, J. J Langberg, and H. U Klein Non-invasive assessment of fibrillatory activity in patients with paroxysmal and persistent atrial fibrillation using the Holter ECG Cardiovasc Res, October 1, 1999; 44(1): 60 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Paydak, J. G. Kall, M. C. Burke, D. Rubenstein, D. E. Kopp, R. J. Verdino, and D. J. Wilber Atrial Fibrillation After Radiofrequency Ablation of Type I Atrial Flutter : Time to Onset, Determinants, and Clinical Course Circulation, July 28, 1998; 98(4): 315 - 322. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Yue, J. Feng, R. Gaspo, G.-R. Li, Z. Wang, and S. Nattel Ionic Remodeling Underlying Action Potential Changes in a Canine Model of Atrial Fibrillation Circ. Res., October 19, 1997; 81(4): 512 - 525. [Abstract] [Full Text]
|
|