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Effect of Amiodarone on Dispersion of Atrial Refractoriness and Cycle Length in Patients with Atrial Fibrillation
Author(s) -
Fynn Simon P.,
Todd Derick M.,
Julian W.,
Hobbs C.,
Armstrong Karen L.,
Fitzpatrick P.,
Garratt Clifford J.
Publication year - 2003
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2003.02388.x
Subject(s) - medicine , amiodarone , refractory period , cardiology , sinus rhythm , atrial fibrillation , cardioversion , coronary sinus , anesthesia
Amiodarone is effective in preventing the recurrence of atrial fibrillation (AF) after cardioversion (CV). Dispersion of atrial refractoriness may be relevant to the generation of AF. We designed a study to determine the electrophysiologic effects of amiodarone in patients with previous early recurrence of AF after CV.Methods and Results: Fifteen patients with previous AF recurrence (without antiarrhythmic drugs) after CV (CV1) were selected for amiodarone therapy and repeat CV (CV amio ). Prior to CV1, mean AF cycle length (AFCL) had been recorded at four atrial sites (right atrial appendage [RAA], distal coronary sinus [DCS], right atrial lateral wall [LAT], and interatrial septum [IAS]) and dispersion of AFCL had been calculated. These patients were treated with amiodarone and, prior to CV amio , AFCL was recorded at the four atrial sites as for CV1. Between CV1 and CV amio , AFCL increased at all atrial sites:153 ± 13 msecto179 ± 14 msecat RAA,144 ± 12 msecto174 ± 18 msecat DCS,158 ± 13 msecto182 ± 16 msecat LAT, and161 ± 18 msecto181 ± 17 msecat IAS. Dispersion of AFCL decreased from24 ± 10 msecat CV1 to15 ± 11 msecatCV amio (P = 0.01). The median time in sinus rhythm increased from 3.12 hours post CV1 to 28 days postCV amio (P < 0.02).Conclusion: Amiodarone causes a reduction in the dispersion of AFCL. This action may be relevant to the beneficial effects of amiodarone in patients with AF.(J Cardiovasc Electrophysiol, Vol. 14, pp. 485‐491, May 2003)