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Tedisamil: master switch of nature?
1Doggrell Biomedical Communications, 47 Caronia Crescent, Lynfield, Auckland, New Zealand. s_doggrell@yahoo.com
Expert Opinion on Investigational Drugs
|December 16, 2000
Summary
Tedisamil is a bradycardic agent that inhibits potassium channels, potentially benefiting ischemic heart disease by reducing oxygen demand. However, its clinical use is limited by an increase in blood pressure.
Area of Science:
- Cardiovascular pharmacology
- Electrophysiology
Background:
- Decreasing heart rate is beneficial in ischemic heart disease.
- Tedisamil is a bradycardic agent that inhibits various potassium currents.
Purpose of the Study:
- To evaluate the electrophysiological and anti-arrhythmic effects of tedisamil.
- To assess the potential of tedisamil as a treatment for ischemic heart disease.
Main Methods:
- Inhibition of transient outward current (I(to)), potassium current (IK), K(ATP), and chloride channels.
- Prolongation of cardiac action potentials and QT interval.
- Assessment in animal models of arrhythmias and clinical trials.
Main Results:
- Tedisamil exhibits anti-arrhythmic properties and reduces myocardial oxygen demand.
- It prolongs action potentials and increases refractoriness.
- Clinical trials indicate Class III anti-arrhythmic activity, with no effect on inotropism in coronary artery disease but an increase in blood pressure.
Conclusions:
- Potassium channel blockade with tedisamil offers a potential anti-ischemic mechanism in coronary artery disease.
- Its effectiveness in heart failure is limited by increased blood pressure.
- A bradycardic agent without hypertensive effects would be advantageous for ischemic heart disease.