In patch-clamped membranes from neonatal rat cardiocytes, elementary Na + currents were recorded at 19° C for study of the inhibitory influence of several antiarrhythmic drugs including lidocaine, diprafenone, propafenone, and prajmalium on DPI-modified cardiac Na L ocal anesthetics and related antiarrhythmic drugs compose a structurally heterogeneous group of organic compounds capable of interacting with Na + channels in excitable membranes, including cardiac cells. Several lines of evidence strongly support the assumption that a channel-associated binding site exists 1 -3 whose interaction or binding with these drugs will finally block the channel and hinder sodium ions from passing through the pore. The resultant decrease in excitability may be an antiarrhythmic principle in heart From the Physiological Institute of the University Freiburg Freiburg/Br., Federal Republic of Germany.Supported by a grant of the Deutsche Forschungsgemeinschaft (Ko 778/2-1), Bonn, Federal Republic of Germany.Address for correspondence: Professor Dr. M. Kohlhardt, Physiological Institute of the University, Hermann-Herder-Str. 7, D-78 Freiburg/Br., Federal Republic of Germany.Received January 20, 1988; accepted September 28, 1988. to suppress irregular impulses. The remarkably different manifestation of Na + current depression, which attracted considerable theoretical interest and was well documented in numerous biophysical studies during the past years, reflects the combined influence of such factors as voltage, driving rate, and drug hydrophobicity in determination of the strength of blockade of Na + currents. The rather complex block phenomenology finds elegant and conclusive explanations by the models of Hille 2 and Hondeghem and Katzung 3 on the one hand and Starmer et al< on the other hand. The HilleHondeghem-Katzung model postulates a modulated receptor whose drug affinity depends on the channel state, rested or activated/inactivated, while the Starmer model assumes a guarded receptor, that is, drug access is controlled by the channel state. Such modeling of block proved valuable and indispensable in the understanding of some elementary properties of voltage-dependent Na + channels.by guest on May 12, 2018