2013


To access this material please log in or register

Register Authorize
2013/№2

Administration of late sodium channel blockers at management of paroxysmal atrial fibrillation (pilot study)

Tatarskiy B. A.
Federal State Budgetary Institution, “North-West Federal Medical Research Center” of the RF Ministry of Health Care, Akkuratova 2, St.-Petersburg 197341

Keywords: late sodium-channel blockers, treatment, atrial fibrillation

DOI: 10.18087/rhj.2013.2.1740

Selection of a safe and effective drug is an important problem at treatment of atrial fibrillation (AF). Though some antiarrhythmic drugs are regularly administered to the AF patients, many of them has adverse effects, such as organ toxicity or ventricular arrhythmias. IC Class drugs (propafenone and flecainide) for oral reduction of arrhythmia are widely used in patients with rare and well tolerated AF episodes. However their administration is limited by presence of structural heart diseases. The article provides the first experience of late sodium-channel blocker administration to relief AF episodes in patients with structural changes of the heart during long-term follow-up.
  1. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. 1998;82 (8A): 2N-9N.
  2. Benjamin E, Levy D, Vasiri S et al. Independent risk factors for atrial fibrillation in a population-based cohort: The Framingham heart study. JAMA. 1994;271 (11):840–844.
  3. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31 (19):2369–429.
  4. Wann LS, Curtis AB, January CT et al. 2011 ACCF / AHA / HRS focused update on the management of patients with atrial fibrillation (Updating the 2006 Guideline): a report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. Heart Rhythm. 2011;8 (1):157–176.
  5. Savelieva I, Camm J. Anti-arrhythmic drug therapy for atrial fibrillation: current anti-arrhythmic drugs, investigational agents, and innovative approaches. Europace. 2008;10 (6):647–665.
  6. Татарский Б. А., Сулимов В. А., Попов С. В. Идиопатическая форма фибрилляции предсердий: подходы к выбору антиаритмической терапии. – Томск: STT, 2009. – 302 c.
  7. Morrow JP, Cannon CP, Reiffel JA. New antiarrhythmic drugs for establishing sinus rhythm in atrial fibrillation: what are our therapies likely to be by 2010 and beyond? Am Heart J. 2007;154 (5):824–829.
  8. Mazzini MJ, Monahan KM. Pharmacotherapy for atrial arrhythmias: present and future. Heart Rhythm. 2008;5 (6 Suppl): S26–31.
  9. Татарский Б. А. Альтернативные подходы к лечению пароксизмальной формы фибрилляции предсердий. Вестник Российской академии медицинских наук: ежемесячный научно-теоретический журнал. 2007;4:3–9.
  10. Azpitarte J, Alvarez M, Baún O et al. Value of single oral loading dose of propafenone in converting recent-onset atrial fibrillation. Results of a randomized, double-blind, controlled study. Eur Heart J. 1997;18 (10):1649–1654.
  11. Alboni P, Botto GL, Baldi N et al. Outpatient treatment of recent-onset atrial fibrillation with the «pill-in-the-pocket» approach. N Engl J Med. 2004;351 (23):2384–2391.
  12. Capucci A, Villani GQ, Piepoli MF, Aschieri D. The role of oral 1C antiarrhythmic drugs in terminating atrial fibrillation. Curr Opin Cardiol. 1999;14 (1):4–8.
  13. Capucci A, Boriani G, Botto GL et al. Conversion of recent-onset atrial fibrillation by a single oral loading dose of propafenone or flecainide. Am J Cardiol. 1994;74 (5):503–505.
  14. Botto GL, Bonini W, Broffoni T et al. Conversion of recent onset atrial fibrillation with single loading oral dose of propafenone. Pacing Clin Electrophysiol. 1996;19 (11 Pt 2):1939–1943.
  15. Boriani G, Capucci A, Lenzi T et all. Propafenone for conversion of recent-onset atrial fibrillation: a controlled comparison between oral loading dose and intravenous administration. Chest. 1995;108 (2):355–358.
  16. Botto GL, Bonini W, Broffoni T et al. Randomized, crossover, controlled comparison of oral loading versus intravenous infusion of propafenone in recent-onset atrial fibrillation. Pacing Clin Electrophysiol. 1998;21 (11 Pt 2):2480–2484.
  17. Antzelevitch C, Belardinelli L, Zygmunt AC et al. Electrophysiologic effects of ranolazine, a novel antianginal agent with antiarrhythmic properties. Circulation. 2004;110 (8):904–910.
  18. Belardinelli L, Shryock JC, Fraser H. Inhibition of the late sodium current as a potential cardioprotective principle: effects of the late sodium current inhibitor ranolazine. Heart. 2006;92 (Suppl 4):iv6‑iv14.
  19. Stone P. Review Ranolazine: new paradigm for management of myocardial ischemia, myocardial dysfunction, and arrhythmias. Cardiol Clin. 2008;26 (4):603–614.
  20. Burashnikov A, Di Diego JM, Zygmunt AC et al. 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. Circulation. 2007;116 (13):1449–1457.
  21. Roden D. Risks and benefits of antiarrhythmic therapy. N Engl J Med. 1994;331 (12):785–791.
  22. Burashnikov A, Antzelevitch C. Can inhibition of IKur promote atrial fibrillation? Heart Rhythm. 2008 Sep;5 (9):1304–1309.
  23. Antzelevitch C, Burashnikov A, Sicouri S. Electrophysiologic basis for the antiarrhythmic actions of ranolazine. Heart Rhythm. 2011;8 (8):1281–1290.
  24. Schram G, Zhang L, Derakhchan K et al. Ranolazine: ion-channel-blocking actions and in vivo electrophysiological effects. Br J Pharmacol. 2004;142 (8):1300–1308.
  25. Schotten U, Verheule S, Kerfant BG, Greiser M. Enhanced late Na currents in atrial fibrillation: new drug target or just an epiphenomenon? J Am Coll Cardiol. 2010;55 (21):2343–2345.
  26. Scirica BM, Morrow DA, Hod H et al. Effect of ranolazine, an antianginal agent with novel electrophysiological properties, on the incidence of arrhythmias in patients with non ST-segment elevation acute coronary syndrome: results from the Metabolic Efficiency With Ranolazine for Less Ischemia in Non ST-Elevation Acute Coronary Syndrome Thrombolysis in Myocardial Infarction 36 (MERLIN-TIMI 36) randomized controlled trial. Circulation. 2007;116 (15):1647–1652.
  27. Murdock DK, Kersten M, Kaliebe J, Larrain G. The use of oral ranolazine to convert new or paroxysmal atrial fibrillation: a review of experience with implications for possible «pill in the pocket» approach to atrial fibrillation. Indian Pacing Electrophysiol J. 2009;9 (5):260–267.
  28. Miles R, Passman R, Murdock D. Comparison of effectiveness and safety of ranolazine versus amiodarone for preventing atrial fibrillation after coronary artery bypass grafting. Am J Cardiol. 2011;108 (5):673–676.
Tatarskiy B. A. Administration of late sodium channel blockers at management of paroxysmal atrial fibrillation (pilot study). Russian Heart Journal. 2013;12(2):102-106

To access this material please log in or register

Register Authorize
Ru En