Effect of E-4031, a new class III antiarrhythmic drug, on reentrant ventricular arrhythmias: comparison with conventional class I drugs

Cardiovasc Drugs Ther. 1993 Aug:7 Suppl 3:621-6. doi: 10.1007/BF00877629.

Abstract

We evaluated the antiarrhythmic efficacy of E-4031, a new class III drug, and compared it with that of conventional class I and II antiarrhythmic agents in terms of electrophysiological actions on refractoriness and conduction in a 7-day-old canine model of myocardial infarction. Sustained monomorphic VT was reproducibly induced in 26 dogs by a premature stimulation method from the right ventricle. Class I drugs (disopyramide, aprindine, flecainide) prevented VT induction in 5 of 13 dogs, and propranolol and E-4031 prevented it in 6 of 6 and 6 of 7 dogs, respectively. The effective refractory period (ERP) was determined at 47 epicardial sites overlying the infarct in each experiment by a S1S2 method. The standard deviation (SD) of the mean ERP of these sites was used as an index of ERP dispersion. The extent of ERP prolongation produced by class I drugs and E-4031 was significantly more marked than that produced by propranolol. However, the SD was increased by class I drugs and E-4031, but not by propranolol. Class I drugs increased the ERP dispersion mainly by an effect on the transmural infarct zone in which the control ERP was more prolonged than in the normal zone. E-4031 tended to prolong the ERP in both the normal and infarct zones, and had a minimal tendency to increase ERP dispersion. In contrast, propranolol decreased the ERP dispersion between zones. Conduction velocity calculated by epicardial mapping was significantly decreased by flecainide, but not by E-4031. We conclude that the antiarrhythmic effect of E-4031 depends largely on its ability to prolong refractoriness without suppressing conduction.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Anti-Arrhythmia Agents / pharmacology*
  • Aprindine / pharmacology
  • Arrhythmias, Cardiac / drug therapy*
  • Disease Models, Animal
  • Disopyramide / pharmacology
  • Dogs
  • Electrophysiology
  • Flecainide / pharmacology
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / physiopathology
  • Piperidines / pharmacology*
  • Potassium Channel Blockers
  • Pyridines / pharmacology*
  • Tachycardia, Ventricular / drug therapy

Substances

  • Anti-Arrhythmia Agents
  • Piperidines
  • Potassium Channel Blockers
  • Pyridines
  • E 4031
  • Aprindine
  • Disopyramide
  • Flecainide