Effects of Verapamil and Procainamide on Acute Atrial Electrical Remodeling Induced by Short-term Rapid Atrial Pacing in Humans
Atrial electrical remodeling (ER) after spontaneous or pacing-induced atrial fibrillation has been previously described in humans. We investigated atrial ER induced by a 5-minute period of rapid atrial pacing and the pharmacologic effects of verapamil and procainamide on this atrial ER phenomenon. T...
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| Format: | Article |
| Language: | English |
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Wiley
2007-12-01
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| Series: | Kaohsiung Journal of Medical Sciences |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X08700585 |
| _version_ | 1818574242142224384 |
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| author | Chih-Sheng Chu Kun-Tai Lee Kai-Hong Cheng Tsung-Hsien Lin Min-Yi Lee Wen-Choi Voon Sheng-Hsiung Sheu Wen-Ter Lai |
| author_facet | Chih-Sheng Chu Kun-Tai Lee Kai-Hong Cheng Tsung-Hsien Lin Min-Yi Lee Wen-Choi Voon Sheng-Hsiung Sheu Wen-Ter Lai |
| author_sort | Chih-Sheng Chu |
| collection | DOAJ |
| description | Atrial electrical remodeling (ER) after spontaneous or pacing-induced atrial fibrillation has been previously described in humans. We investigated atrial ER induced by a 5-minute period of rapid atrial pacing and the pharmacologic effects of verapamil and procainamide on this atrial ER phenomenon. The atrial effective refractory periods (ERPs) at drive cycle lengths of 400 (ERP400) and 600 (ERP600) ms, at five representative atrial sites (high right atrium [HRA]; proximal, middle and distal coronary sinus; interarrial septum), were determined in 20 patients at baseline and immediately after cessation of a 5-minute period of rapid pacing from the HRA at a rate of 150 bpm. The degrees of atrial ERP400 and ERP600 shortening after pacing were calculated as acute atrial ER. The same protocol was repeated in another 15 patients after intravenous administration of verapamil (0.15 mg/kg) and in another 15 patients after intravenous administration of procainamide (15 mg/kg). The results demonstrated that, in the control state acute atrial ER can be significantly demonstrated at each atrial representative site (p<0.001). The mean ERP400 and ERP600 shortenings were 9+4% and 8+4%, respectively. After procainamide infusion, but not after verapamil, baseline ERP400 and ERP600 values were significantly prolonged at the five representative atrial sites (p < 0.01). Acute atrial ER could still be demonstrated at each atrial site after procainamide or verapamil infusion (p < 0.001). In conclusion, acute atrial ER can be demonstrated after only a 5-minute period of rapid atrial pacing in humans. Intravenous verapamil or procainamide does not abolish this ER process. |
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| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-15T00:23:58Z |
| publishDate | 2007-12-01 |
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| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-998ca355c11448d4828dad1d627c8c2d2022-12-21T22:42:13ZengWileyKaohsiung Journal of Medical Sciences1607-551X2007-12-01231259961010.1016/S1607-551X(08)70058-5Effects of Verapamil and Procainamide on Acute Atrial Electrical Remodeling Induced by Short-term Rapid Atrial Pacing in HumansChih-Sheng Chu0Kun-Tai Lee1Kai-Hong Cheng2Tsung-Hsien Lin3Min-Yi Lee4Wen-Choi Voon5Sheng-Hsiung Sheu6Wen-Ter Lai7Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanAtrial electrical remodeling (ER) after spontaneous or pacing-induced atrial fibrillation has been previously described in humans. We investigated atrial ER induced by a 5-minute period of rapid atrial pacing and the pharmacologic effects of verapamil and procainamide on this atrial ER phenomenon. The atrial effective refractory periods (ERPs) at drive cycle lengths of 400 (ERP400) and 600 (ERP600) ms, at five representative atrial sites (high right atrium [HRA]; proximal, middle and distal coronary sinus; interarrial septum), were determined in 20 patients at baseline and immediately after cessation of a 5-minute period of rapid pacing from the HRA at a rate of 150 bpm. The degrees of atrial ERP400 and ERP600 shortening after pacing were calculated as acute atrial ER. The same protocol was repeated in another 15 patients after intravenous administration of verapamil (0.15 mg/kg) and in another 15 patients after intravenous administration of procainamide (15 mg/kg). The results demonstrated that, in the control state acute atrial ER can be significantly demonstrated at each atrial representative site (p<0.001). The mean ERP400 and ERP600 shortenings were 9+4% and 8+4%, respectively. After procainamide infusion, but not after verapamil, baseline ERP400 and ERP600 values were significantly prolonged at the five representative atrial sites (p < 0.01). Acute atrial ER could still be demonstrated at each atrial site after procainamide or verapamil infusion (p < 0.001). In conclusion, acute atrial ER can be demonstrated after only a 5-minute period of rapid atrial pacing in humans. Intravenous verapamil or procainamide does not abolish this ER process.http://www.sciencedirect.com/science/article/pii/S1607551X08700585antiarrhythmic agentseffective refractory periodelectrical remodelingrapid atrial pacing |
| spellingShingle | Chih-Sheng Chu Kun-Tai Lee Kai-Hong Cheng Tsung-Hsien Lin Min-Yi Lee Wen-Choi Voon Sheng-Hsiung Sheu Wen-Ter Lai Effects of Verapamil and Procainamide on Acute Atrial Electrical Remodeling Induced by Short-term Rapid Atrial Pacing in Humans Kaohsiung Journal of Medical Sciences antiarrhythmic agents effective refractory period electrical remodeling rapid atrial pacing |
| title | Effects of Verapamil and Procainamide on Acute Atrial Electrical Remodeling Induced by Short-term Rapid Atrial Pacing in Humans |
| title_full | Effects of Verapamil and Procainamide on Acute Atrial Electrical Remodeling Induced by Short-term Rapid Atrial Pacing in Humans |
| title_fullStr | Effects of Verapamil and Procainamide on Acute Atrial Electrical Remodeling Induced by Short-term Rapid Atrial Pacing in Humans |
| title_full_unstemmed | Effects of Verapamil and Procainamide on Acute Atrial Electrical Remodeling Induced by Short-term Rapid Atrial Pacing in Humans |
| title_short | Effects of Verapamil and Procainamide on Acute Atrial Electrical Remodeling Induced by Short-term Rapid Atrial Pacing in Humans |
| title_sort | effects of verapamil and procainamide on acute atrial electrical remodeling induced by short term rapid atrial pacing in humans |
| topic | antiarrhythmic agents effective refractory period electrical remodeling rapid atrial pacing |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X08700585 |
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