Topical Application of a Biodegradable Disc With Amiodarone for Atrial Fibrillation

Clinical efficacy of epicardial application of drug-releasing hydrogels to prevent postoperative atrial fibrillation

“…A few studies researching the effectiveness of the topical application of a biodegradable disc with amiodarone or amiodarone-eluting bilayered patch have reported encouraging results. 11,12 However, the amount of exposure to the atrial epicardial surface is often limited using those applications. Biatrial epicardial application of drugreleasing hydrogel might offer the advantage of a more localized (biatrial targeted) drug delivery.…”

The randomized study of epicardial application of hydrogel with amiodarone for prevention of postoperative atrial fibrillation in patients after coronary artery bypass grafting

“…В литературе имеются работы, где показано, что уровень лейкоцитов и нейтрофилов является специфическим независимым предиктором ПОФП [14]. Эти работы демонстрировали воспалительный характер в генезе ПОФП, в частности, изучали использование противовоспалительного действия статинов в профилактике ПОФП [15].…”

Intrapericardial Amiodarone for the Prevention of Postoperative Atrial Fibrillation

“…Unlike catheter‐based intrapericardial infusion of drug solutions, epicardial application of drug‐releasing biomaterials might offer a longer drug–tissue contact and the advantage of a more localized (atrial‐specific) drug delivery while ventricular and systemic drug concentrations are minimized. The effectiveness of this method was investigated in studies that used a drug‐eluting bilayered patch, a biodegradable disc sutured to the atrium, or sprayable adhesive hydrogel as an amiodarone‐releasing biomaterial …”

“…The effectiveness of this method was investigated in studies that used a drugeluting bilayered patch, a biodegradable disc sutured to the atrium, or sprayable adhesive hydrogel as an amiodarone-releasing biomaterial. [29][30][31] Bolderman et al 29 studied the effectiveness of atrium-targeted drug delivery through an amiodaroneeluting atrial bilayered patch in reducing vulnerability to atrial tachyarrhythmias in goats. They demonstrated that right atrial epicardial application of a bilayered patch, with an amiodarone-loaded poly(ethylene glycol)based matrix facing the epicardium and an impermeable poly(lactide-co-caprolactone) backing layer facing the pericardium, produced therapeutic atrial drug concentrations and sustained significant atrial antiarrhythmic effects (increased effective refractory periods and conduction times and decreased vulnerability to burst pacing-induced atrial tachyarrhythmias) up to 28 days after patch application with minimal ventricular and systemic drug levels.…”

“…Bolderman et al 29 2010 Goats Atrium-specific drug delivery through an amiodarone-eluting patch produces therapeutic atrial drug concentrations with minimal ventricular and systemic drug levels, demonstrating sustained targeted drug delivery to a specific heart chamber is feasible and might reduce the risk for ventricular and extracardiac adverse effects and that application of amiodarone-eluting patches is a promising strategy to prevent POAF. Takeda et al 30 2011 Japanese white rabbits Atrial topical application of a biodegradable dextran disc with amiodarone may be a less invasive and effective therapeutic option for preventing POAF. Bolderman et al 31 2011 Goats Epicardial application of an amiodarone-releasing hydrogel reduces atrial vulnerability to tachyarrhythmias up to three weeks while extracardiac drug levels remain low, indicating that amiodaronereleasing hydrogel could be applied during cardiac surgery to prevent POAF at minimal risk for extracardiac adverse side effects.…”