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European Heart Journal 1986 7(2):158-164;
Copyright © 1986 by the European Society of Cardiology.
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© 1986 The European Society of Cardiology

Effects of intravenous ajmaline on atrial excitability and conduction in man

F. ARRIBAS, F. G. COSIO, J. PALACIOS, M. ALONSO and M. LOPEZ-GIL

Cadiology Service, Hospital l de Octubre, and Medicine Department, Universidad Complutense, Medical School Madrid, Spain

Received 16 July 1985; revised 13 September 1985; .

Address for correspondence: Dr Francisco G Cosio, Servicio de Cardiologia, Hospital l de Octubre, Km 5, 4 Carretera Andalucia, 28026 Madrid, Spain

Abstract

low conduction of early extrastimuli and short refractory periods are some of the factors underlying atrial fibrillation in man. In order to study the effect of ajmaline, a class I antiarrhythmic agent, on these variables, we have performed electrophysiologic studies in 13 patients with and without atrial arrhythmias, before and after the intravenous administration of 1 mg Kg –1 of ajmaline chlorhydrate. During paced rhythm with a 600 ms cycle length, extrastimuli were applied to the right atrial appendage, and conduction to the low septal right atrium and the coronary sinus were measured.

Ajmaline prolonged P wave duration from 111 ± 15 to 140 ± 24 ms (P<0.001), conduction of baseline stimuli to low septal right atrium from 69 ± 14 to 95 ± 21 ms (P<0.001) and to coronary sinus from 127 ± 18 to 165 ± 29 ms (P<0.001). Atrial effective refractory period increased from 207 ± 23 to 255 ± 27 ms (P< 0001). Maximum conduction delay of early extrastimuli decreased at the low septal right atrium from 43 ± 22 to 29 ± 16 ms (P<0.25) and at the coronary sinus from 47 ± 22 to 21 ± 14 ms (P<0.001).

These results show interesting electrophysiologic effects of ajmaline on atrial tissue, with reversion of some of the abnormalities underlying atrial fibrillation, and suggest an antiarrhythmic effect.

Key Words: Atrial fibrillation • ajmaline • atrial conduction


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