Atrial flutter termination by overdrive transesophageal pacing and the facilitating effect of oral propafenone

Doni, Flavio; Bella, Paolo Della; Kheir, Antoine; Manfredi, Margherita; Piemonti, C.; Staffiere, E; Rimondini, Andrea; Fiorentini, Cesare

doi:10.1016/s0002-9149(99)80350-6

Cited by 27 publications

(9 citation statements)

References 24 publications

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“…Intravenous flecainide increases CL and EG 8 without significant changes in refractoriness. Acute oral administration of propafenone alters conduction velocity more than refractoriness so that increase of EG is evoked 16 …”

Section: Discussionmentioning

confidence: 99%

“…Atrial overdrive pacing is a widely accepted technique for conversion of atrial flutter 2,38–46 . Both class IA 5,13–15 and IC drugs 16,17 increase EG during atrial flutter and increase the rate of conversion after overdrive pacing 13–16,47 . Class III drugs reduce the duration of EG while increasing the success rate of overdrive pacing 9,18,28 .…”

Section: Discussionmentioning

confidence: 99%

“…Both class IA 5,13–15 and IC drugs 16,17 increase the EG during atrial flutter, whereas class III drugs reduce the duration of EG 9,11,18,19 . Amiodarone is a powerful class III antiarrhythmic drug with major action on repolarization without reverse use dependence 20–22 and with additional action on the fast Na current and calcium channel, together with noncompetitive a‐ and β‐antagonistic actions 23,24 .…”

Section: Introductionmentioning

confidence: 99%

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Effect of Chronic Amiodarone Therapy on Excitable Gap During Typical Human Atrial Flutter

Zimmermann

2004

Cardiovasc electrophysiol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Chronic Amiodarone Therapy on Excitable Gap During Typical Human Atrial Flutter

Zimmermann

2004

Cardiovasc electrophysiol

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“…Индуцированная электрокардиостимуляцией ФП, как правило, сопровождается меньшей частотой желудочковых сокращений, которая легче, чем при ТП, контролируется фармакотерапией. Доказано, что применение некоторых антиаритмиков I и III классов (новокаинамид, дизопирамид, пропафенон, ибутилид) перед ЭКС, «облегчая проникновение» импульса в цепь re-entry, увеличивают её эффективность и уменьшают риск провокации ФП [14,15]. Так, Stambler B.S.…”

Section: лечение трепетания предсердийunclassified

Atrial Flutter: Contemporary Possibilities of Diagnosis and Treatment

Bunin¹

2011

Racionalʹnaâ farmakoterapiâ v kardiologii

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Трепетание предсердий: современные возможности диагностики и лечения Ю.А. Бунин* Российская медицинская академия последипломного образования. 123995, Москва, ул. Баррикадная, д. 2/1 Диагностика и лечение трепетания предсердий (ТП) является актуальной проблемой. Представлены данные эпидемиологии, электрофизиологические механизмы и современная классификация ТП, алгоритм лечения, который предложен ведущими экспертами. Показано, что в лечении ТП, как и при лечении фибрилляции предсердий (ФП), можно выделить 2 стратегии: «контроль ритма» и «контроль частоты». Отмечено, что снижение частоты желудочковых сокращений у больных с ТП, значительно труднее, чем при ФП. Описаны показания к различным видам терапии ТП: фармакологической терапии, электрокардиостимуляции и электроимпульсной терапии, а также к хирургическим методам лечения. Ключевые слова: трепетание предсердий, диагностика, лечение.

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“…Several Class I drugs like procainamide, disopyramide, flecainide, and propafenone and Class III drugs like ibutilide and amiodarone facilitate the conversion of atrial flutter and reduce the occurrence of AF by atrial overdrive pacing. [67][68][69][70][71][72][73][74] The possible mechanism may be widening of the excitable gap by antiarrhythmic drugs that allows the stimulus to penetrate the reentrant circuit more easily.…”

Section: Combination Of Antiarrhythmic Drugs With Atrial Overdrive Pamentioning

confidence: 99%

Mechanisms of Antiarrhythmic Drug Action on Termination of Atrial Flutter

Tai

Chen

2001

Pacing Clinical Electrophis

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Atrial flutter is an important arrhythmia in clinical practice. Although the reentrant circuit of human typical atrial flutter is well characterized, the action of antiarrhythmic drugs on this tachycardia is less understood. Based on the recent clinical trials, pure Class III drugs like ibutilide or dofetilide are more effective in acute termination of human atrial flutter than Class I drugs like procainamide or flecainide. The mechanisms of drug induced termination of atrial flutter include refractory block due to cycle length oscillation, fixed block due to a reduced safety factor for conduction, or a collision of opposing wavefronts due to loss of the lateral boundaries or return reexcitation. Because ventricular proarrhythmia is a major concern with ibutilide or dofetilide therapy, development of new drugs with more specific target profiles is a future direction for treatment of human atrial flutter.

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Atrial flutter termination by overdrive transesophageal pacing and the facilitating effect of oral propafenone

Cited by 27 publications

References 24 publications

Effect of Chronic Amiodarone Therapy on Excitable Gap During Typical Human Atrial Flutter

Effect of Chronic Amiodarone Therapy on Excitable Gap During Typical Human Atrial Flutter

Atrial Flutter: Contemporary Possibilities of Diagnosis and Treatment

Mechanisms of Antiarrhythmic Drug Action on Termination of Atrial Flutter

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