Document Detail


Comparison in the same patient of aberrant conduction and bundle branch reentry after dofetilide, a new selective class III antiarrhythmic agent.
MedLine Citation:
PMID:  7685880     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Dofetilide may induce aberrant intraventricular conduction due to its Class III effect. This report describes an atrial fibrillation patient in whom intraventricular conduction was studied before and after dofetilide using multiple endocardial recordings. Dofetilide provoked aberrant conduction during atrial fibrillation, and aberrancy could be mimicked with programmed atrial stimulation after restoration of sinus rhythm. However, during right ventricular stimulation, isolated bundle branch reentrant beats were recorded after induction of critical retrograde conduction delays. This occurred in the setting of relatively large differences in refractoriness between the right bundle branch and the right ventricular myocardium. This favored distal retrograde bundle branch block during ventricular extrastimulation, in turn enhancing bundle branch reentry. This potential proarrhythmic mechanism deserves close attention in the further development of dofetilide and also of other new "pure" Class III agents.
Authors:
H J Crijns; J H Kingma; A T Gosselink; K Lie
Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  16     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-07-22     Completed Date:  1993-07-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1006-16     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospital Groningen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Action Potentials
Adult
Anti-Arrhythmia Agents / therapeutic use*
Atrial Fibrillation / drug therapy,  physiopathology
Bundle of His / drug effects,  physiopathology
Cardiac Pacing, Artificial
Electrocardiography
Heart Conduction System / drug effects,  physiopathology*
Humans
Male
Phenethylamines / therapeutic use*
Refractory Period, Electrophysiological
Sulfonamides / therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Phenethylamines; 0/Sulfonamides; 115256-11-6/dofetilide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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