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Class III Antiarrhythmic Action

  • Chapter
Antiarrhythmic Drugs

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 89))

Abstract

Class III antiarrhythmic action, e.g. the principle of delayed myocardial repolarization as an antiarrhythmic action, was described in 1970. This mode of action has become increasingly interesting with the increasing knowledge about mechanisms involved in initiation and perpetuation of cardiac arrhythmias and with the increasing number of antiarrhythmic drugs belonging to this class. Consequently, the possible class III mode of action of different antiarrhythmic drugs has been analyzed also in the intact human heart. For this purpose, several different methods have been applied. The present paper aims to describe some basic facts of importance for the demonstration and interpretation of delayed repolarization as an antiarrhythmic action in the clinical setting and to give some examples of this mechanism.

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References

  • Armenta J, Zambrano A, Duclos F (1970) Effectos de la amiodarona sobra la repolarizacion ventricular. Nota clinica. Rev Esp Cardiol 23: 409–419

    Google Scholar 

  • Bexton RS, Camm AJ (1982) Drugs with a class III antiarrhythmic action. Pharmacol Ther 17: 315–355

    Article  Google Scholar 

  • Blomstròm P, Bodnar J, Edvardsson N, B-Lundqvist C, Olsson SB (1987) Acute effect of intravenous amiodarone on ventricular refractoriness and repolarization. Pace 10 (40:11): 1004

    Google Scholar 

  • Blomström-Lundqvist C, Dohnal M, Hirsch I, Lindblad A, Hjalmarsson Ä, Olsson SB, Edvardsson N (1986) Effect of long term treatment with metoprolol and Sotalol on ventricular repolarization measured by use of transoesophageal atrial pacing. Br Heart J 55: 181–186

    Article  PubMed  Google Scholar 

  • Bonatti V, Finardi A, Cabasson J, Botti G (1976) L’effetto della bunaftine sui potenzi- ali d’azione monofascici del miocardio atriale e ventricolare destro nell’uomo. G Ital Cardiol 6: 440–449

    PubMed  CAS  Google Scholar 

  • Bonatti V, Rolli A, Botti G (1985) Monophasic action potential studies in human subjects with prolonged ventricular repolarization and long QT syndromes. Eur Heart J [Suppl D]6: 131–143

    Google Scholar 

  • Brachmann J, Senges J, Lengfelder W, Jauernig R, Rizos I, Czygan E, Cobbe SM, Kubler W (1985) Contribution of delayed ventricular repolarization to the anti-arrhythmic efficacy of Sotalol. Eur Heart J [Suppl D]6: 171–174

    Google Scholar 

  • Bromberger-Barnea B, Caldini P, Wittenstein GJ (1959) Transmembrane potentials of the normal and hypothermic human heart. Circ Res 7: 138–140

    Google Scholar 

  • Carmeliet E (1977) Repolarisation and frequency in cardiac cells. J Physiol (Paris) 73: 903–923

    Google Scholar 

  • Cotoi S, Gavrilescu S, Pop T, Vicas E (1972) The prognostic value of right atrium monophasic action potential after conversion of atrial fibrillation. Eur J Clin Invest 2: 472–474

    Article  PubMed  CAS  Google Scholar 

  • Debbas NMG, duCailar C, Bexton RS, Demaille JG, Camm AJ, Puech P (1984) The QT interval: a predictor of the plasma and myocardial concentrations of amioda-rone. Br Heart J 51: 316–320

    Article  PubMed  CAS  Google Scholar 

  • Donaldson RM, Rickards A (1982) Evaluation of drug-induced changes in myocardial repolarization using the paced evoked response. Br Heart J 48: 381–387

    Article  Google Scholar 

  • Edvardsson N, Olsson SB (1981a) Effects of acute and chronic beta receptor blockade on ventricular repolarisation in man. Br Heart J 45: 628–636

    Article  Google Scholar 

  • Edvardsson N, Olsson SB (1981b) Effect of intravenous melperone on atrial repolarization in man. Scand J Clin Lab Invest 41: 87–90

    Article  Google Scholar 

  • Edvardsson N, Hirsch I, Emanuelsson H, Ponten J, Olsson SB (1980) Sotalol-induced delayed ventricular repolarization in man. Eur Heart J 1: 335–343

    Google Scholar 

  • Edvardsson N, Hirsch I, Olsson SB (1984 a) Right ventricular monophasic action potentials in healthy young men. Pace 7: 813–821

    Google Scholar 

  • Edvardsson N, Hirsch I, Amlie J, Olsson SB (1984 b) Class III antiarrhythmic activity of D-sotalol on human ventricular refractoriness and repolarization (Abstr). Circulation [Suppl 2]70:443

    Google Scholar 

  • Edvardsson N, Hirsch I, Olsson SB (1984 c) Acute effects of lignocaine, procainamide, metoprolol, digoxin and atropine on human myocardial refractoriness. Cardiovasc Res 17: 463–470

    Google Scholar 

  • Edvardsson N, Talwar KK, Hirsch I, Olsson SB (1985) Acute effects of verapamil on the human right atrium and ventricle. Cardiovascular Pharmacotherapy International Symposium, April 22–25, Geneva

    Google Scholar 

  • Fenici R, Marchei M, Bollocci F, Zecchi P (1977) Effect of bunaphtine on right atrial repolarisation in man. Br Heart J 39: 787–794

    Article  Google Scholar 

  • Franz MR, Burkhoff D, Spurgeon H, Weisfeldt ML, Lakatta EG (1986) In vitro validation of a new cardiac catheter technique for recording monophasic action potentials. Eur Heart J 7: 34–41

    PubMed  CAS  Google Scholar 

  • Freedberg As, Papp JG, Vaughan Williams EM (1970) The effect of altered thyroid state on atrial intracellular potentials. J Physiol 207: 357–369

    Google Scholar 

  • Harper RW, Olsson SB, Varnauskas E (1979) Effect of mexiletine on monophasic action potentials recorded from the right ventricle in man. Cardiovasc Res 13: 303–310

    Article  PubMed  CAS  Google Scholar 

  • Janse MJ, Cinca J, Moréna H, Fiolet JW, Kléber AG, de Vries PG, Becker AE, Dürrer D (1979) The “border zone” in myocardial ischemia. An electrophysiological, metabolic and histochemical correlation in the pig heart. Circ Res 44: 576–588

    Google Scholar 

  • Olsson SB (1972) Right ventricular monophasic action potentials during regular rhythm. A heart catheterization in man. Acta Med Scand 151: 145–157

    Google Scholar 

  • Olsson SB, Edvardsson N (1981) Clinical electrophysiologic study of antiarrhythmic properties of flecainide: acute intraventricular delayed conduction and prolonged repolarization in regular paced and premature beats using intracardiac monophasic action potentials with programmed stimulation. Am Heart J 102: 864–871

    Article  Google Scholar 

  • Olsson SB, Cotoi S, Varnauskas E (1971) Monophasic action potential and sinus rhythm stability after conversion of atrial fibrillation. Acta Med Scand 190: 381–387

    Google Scholar 

  • Olsson SB, Brorson L, Varnauskas E (1973) Class 3 anti-arrhythmic action in man. Observations from monophasic action potential recordings and amiodarone treatment. Br Heart J 35: 1255–1259

    Google Scholar 

  • Olsson B, Brorson L, Harper R, Rydén L (1977) Estimation of ventricular refractoriness in man by the extra stimulus method. Cardiovasc Res 2: 31–38

    Google Scholar 

  • Olsson SB, Brorson L, Edvardsson N, Varnauskas E (1985) Estimation of ventricular repolarization in man by monophasic action potential recording technique. Eur Heart J [Suppl D]6: 71–79

    Google Scholar 

  • Platou ES (1982) Class III antiarrhythmic action with special reference to the electrophysiological and haemodynamic effects of melperone. Thesis, University of Tromsö

    Google Scholar 

  • Schwartz PJ (1980) The long QT syndrome. In: Kulbertus HE, Wellens HJJ (eds) Sudden death. Nijhoff, The Hague, pp 358–378

    Chapter  Google Scholar 

  • Singh BN, Vaughan Williams EM (1970) The effect of amiodarone, a new antianginal drug, on intracellular potentials and other properties of isolated cardiac muscle. Br J Pharmacol 39: 657–667

    Google Scholar 

  • Torres V, Tepper D, Flowers BAD, Wynn J, Lam S, Keefe D, Miura DS, Somberg JC (1986) QT Prolongation and the antiarrhythmic efficacy of amiodarone. J Am Coll Cardiol 7: 142–147

    Article  Google Scholar 

  • Vaughan Williams EM (1970) Classification of anti-arrhythmic drugs. In: Sandoe E, Flensted-Jensen E, Olesen KH (eds) Symposium on cardiac arrhythmias. Astra, Södertälje, pp 449–466

    Google Scholar 

  • Vaughan Williams EM (1985) Delayed ventricular repolarization as an anti-arrhythmic principle. Eur Heart J [Suppl D]6: 145–149

    Google Scholar 

  • Vaughan Williams EM, Raine AEG, Cabrera AA, Whyte JN (1975) The effects of pro-longed betaadrenoceptor blockade on heart weight and cardiac intracellular potentials in rabbits. Cardiovasc Res 9: 579–592

    Article  Google Scholar 

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© 1989 Springer-Verlag Berlin Heidelberg

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Olsson, S.B. (1989). Class III Antiarrhythmic Action. In: Vaughan Williams, E.M. (eds) Antiarrhythmic Drugs. Handbook of Experimental Pharmacology, vol 89. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-73666-7_15

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  • DOI: https://doi.org/10.1007/978-3-642-73666-7_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-73668-1

  • Online ISBN: 978-3-642-73666-7

  • eBook Packages: Springer Book Archive

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