Literature DB >> 20478403

Acute dronedarone is inferior to amiodarone in terminating and preventing atrial fibrillation in canine atria.

Alexander Burashnikov1, Luiz Belardinelli, Charles Antzelevitch.   

Abstract

BACKGROUND: Dronedarone is approved by the U.S. Food and Drug Administration for the treatment of patients with atrial fibrillation (AF) as a safe alternative to amiodarone. There are no full-length published reports describing the effectiveness of acute dronedarone use against AF in experimental or clinical studies.
OBJECTIVE: The purpose of this study was to determine the effect of acute dronedarone and amiodarone on electrophysiological parameters, and their anti-AF efficacy in canine isolated arterially perfused right atria.
METHODS: Transmembrane action potentials and pseudoelectrocardiograms were recorded. Acetylcholine (ACh, 1.0 muM) was used to induce persistent AF.
RESULTS: Amiodarone-induced changes were much more pronounced than those of dronedarone on (1) action potential duration (DeltaAPD(90), +51 +/- 17 ms vs. 4 +/- 6 ms, P >.01), (2) effective refractory period (DeltaERP, +84 +/- 23 ms vs. 18 +/- 9 ms, P <.001), (3) diastolic threshold of excitation (DeltaDTE, +0.32 +/- 0.11 mA vs. 0.03 +/- 0.02 mA, P <.001), and (4) V(max) (DeltaV(max), -43 +/- 14% vs. -11 +/- 4%, P <.01, n = 5 to 6; all recorded at 10 muM, cycle length = 500 ms). Persistent AF was induced in 10 of 10 atria exposed to ACh alone; subsequent addition of dronedarone or amiodarone terminated AF in 1 of 7 and 4 of 5 atria, respectively. Persistent ACh-mediated AF was induced in 5 of 6 and 0 of 5 atria pretreated with dronedarone and amiodarone, respectively.
CONCLUSION: The electrophysiological effects and anti-AF efficacy of acute dronedarone are much weaker than those of amiodarone in a canine model of AF. The efficacy of acute dronedarone to prevent induction of acetylcholine-mediated AF as well as to terminate persistent AF in canine right atria is relatively poor. Our data suggest that acute dronedarone is a poor substitute for amiodarone for acute cardioversion of AF or prevention of AF recurrence. Copyright 2010. Published by Elsevier Inc.

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Year:  2010        PMID: 20478403      PMCID: PMC2932819          DOI: 10.1016/j.hrthm.2010.05.019

Source DB:  PubMed          Journal:  Heart Rhythm        ISSN: 1547-5271            Impact factor:   6.343


  32 in total

1.  Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure.

Authors:  Gust H Bardy; Kerry L Lee; Daniel B Mark; Jeanne E Poole; Douglas L Packer; Robin Boineau; Michael Domanski; Charles Troutman; Jill Anderson; George Johnson; Steven E McNulty; Nancy Clapp-Channing; Linda D Davidson-Ray; Elizabeth S Fraulo; Daniel P Fishbein; Richard M Luceri; John H Ip
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2.  SR 33589, a new amiodarone-like antiarrhythmic agent: electrophysiological effects in anesthetized dogs.

Authors:  A Manning; V Thisse; D Hodeige; J Richard; J P Heyndrickx; P Chatelain
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3.  ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation).

Authors:  Valentin Fuster; Lars E Rydén; David S Cannom; Harry J Crijns; Anne B Curtis; Kenneth A Ellenbogen; Jonathan L Halperin; Jean-Yves Le Heuzey; G Neal Kay; James E Lowe; S Bertil Olsson; Eric N Prystowsky; Juan Luis Tamargo; Samuel Wann; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Jeffery L Anderson; Elliott M Antman; Sharon Ann Hunt; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel; Silvia G Priori; Jean-Jacques Blanc; Andrzej Budaj; A John Camm; Veronica Dean; Jaap W Deckers; Catherine Despres; Kenneth Dickstein; John Lekakis; Keith McGregor; Marco Metra; Joao Morais; Ady Osterspey; José Luis Zamorano
Journal:  J Am Coll Cardiol       Date:  2006-08-15       Impact factor: 24.094

4.  Dofetilide in patients with congestive heart failure and left ventricular dysfunction. Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group.

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5.  Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators.

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Journal:  Lancet       Date:  1997-03-08       Impact factor: 79.321

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7.  Dronedarone for maintenance of sinus rhythm in atrial fibrillation or flutter.

Authors:  Bramah N Singh; Stuart J Connolly; Harry J G M Crijns; Denis Roy; Peter R Kowey; Alessandro Capucci; David Radzik; Etienne M Aliot; Stefan H Hohnloser
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8.  In vitro effects of acute amiodarone and dronedarone on epicardial, endocardial, and M cells of the canine ventricle.

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Journal:  J Cardiovasc Pharmacol Ther       Date:  2007-12       Impact factor: 2.457

9.  Atrium-selective sodium channel block as a strategy for suppression of atrial fibrillation: differences in sodium channel inactivation between atria and ventricles and the role of ranolazine.

Authors:  Alexander Burashnikov; José M Di Diego; Andrew C Zygmunt; Luiz Belardinelli; Charles Antzelevitch
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Authors:  C Lafuente-Lafuente; S Mouly; M A Longas-Tejero; J F Bergmann
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  12 in total

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2.  Atrial-selective sodium channel block by dronedarone: sufficient to terminate atrial fibrillation?

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Review 5.  Mechanisms and Drug Development in Atrial Fibrillation.

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Review 6.  Electrophysiologic basis for the antiarrhythmic actions of ranolazine.

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Review 7.  Mechanisms of termination and prevention of atrial fibrillation by drug therapy.

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8.  Appropriate and inappropriate use of dronedarone in 2013.

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Journal:  Curr Treat Options Cardiovasc Med       Date:  2013-08

9.  Safety and efficacy of dronedarone in the treatment of atrial fibrillation/flutter.

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Review 10.  The role of dronedarone in the treatment of atrial fibrillation/flutter in the aftermath of PALLAS.

Authors:  Gerald V Naccarelli; Peter R Kowey
Journal:  Curr Cardiol Rev       Date:  2014-11
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