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European Heart Journal 1988 9(5):489-497;
Copyright © 1988 by the European Society of Cardiology.
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© 1988 The European Society of Cardiology

Clinical cardiac electrophysiologic evaluation of the positive inotropic agent, DPI 201–106

G. S. BUTROUS, N. M. G. DEBBAS, J. ERWIN, D. W. DAVIES, H. P. KELLER*, M. W. LUNNON{dagger}, A. W. NATHAN and A. J. CAMM

Department of Cardiology, St Bartholomew's Hospital London, U.K.
*Biopharmaceutical Dept. Sandoz AG Basle, Switzerland
{dagger}Clinical Research Unit London Sandoz Ltd., Feltham, U.K.

Received 19 June 1987; revised 26 October 1987; .

Address for correspondence: Dr G. S. Butrous, Department of Cardiological Science, St George's Hospital and Medical School, Cranmer Terrace, London SWI7ORE, U.K.

Abstract

DPI 201–106 is a new positive inotropic agent. The cardiac electrophysiology of 16 patients was studied before and during DPI 201–106 administration (loading dose of intravenous DPI 201–106, 1·8 mg kg–1 h–1 administered over 10 min, followed by a maintenance dose of 0·2 mg kg–1 h–1). DPI 201–106 had no effect on the sinus node. The AH interval during fixed-rate atrial pacing became prolonged during DPI 201–106 infusion. There was a significant prolongation of the QT interval [QT (corrected), 417 ± 22 to 502 ± 35 ms, P<0·05; QT (atrial pacing at 600 ms), 374 ±17 to 419 ± 23 ms, P<0·05; QT (ventricular pacing at 600 ms), 409 ± 37 to 449 ± 30 ms, P<0·05]. The ventricular effective refractory period significantly prolonged during DPI 201–106 administration (242 ± 21 to 287 ± 56 ms, P < 0·05), but the supernormal-period duration decreased. The atrial effective refractory period was shortened in four patients and prolonged in one (261 ± 67 to 240 ± 53 ms, NS). The corrected atrial repolarization time (PTac) shortened significantly during DPI 210–106 infusion (479 ± 26 to 445 ± 22 ms at 20 min of the maintenance dose, P<0·05). Atrial fibrillation was initiated in five patients during DPI infusion, but no ventricular arrhythmia was provoked. These findings suggest that DPI 201–106 has novel differential electrophysiological effects on atria and ventricles.

Key Words: DPI • cardiac electrophysiology • QT interval


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