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Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine
Published on: July 7, 2016
Intrapericardial beta-adrenergic blockade with esmolol exerts a potent antitachycardic effect without depressing
Journal of Cardiovascular Pharmacology
|December 16, 2000
Summary
Intrapericardial esmolol effectively suppressed tachycardia without impacting blood pressure or cardiac contractility. This targeted approach offers a potential new method for managing tachycardias in critical care settings.
Area of Science:
- Cardiology
- Pharmacology
- Anesthesiology
Background:
- Hyperadrenergic states can cause tachycardias.
- Systemic beta-blockade treats sinus tachycardia but can reduce blood pressure and contractility.
- Esmolol, a beta-adrenergic blocker, may suppress tachycardia with limited systemic effects when delivered locally.
Purpose of the Study:
- To investigate if intrapericardial beta-adrenergic blockade with esmolol could suppress tachycardia without compromising cardiac contractility.
- To assess the feasibility of a novel transatrial access method for intrapericardial drug delivery.
Main Methods:
- Hemorrhage was used to induce reflex tachycardia in five anesthetized pigs.
- Esmolol (1 mg/kg) was administered either intrapericardially via a new transatrial method or intravenously.
- Hemodynamic parameters including heart rate, blood pressure, and left ventricular dP/dt max were monitored.
Main Results:
- Intrapericardial esmolol suppressed hemorrhage-induced sinus tachycardia similarly to intravenous administration.
- The heart rate reduction effect of intrapericardial esmolol lasted longer than the intravenous route.
- Intrapericardial esmolol did not significantly alter blood pressure or left ventricular contractility, unlike intravenous esmolol.
Conclusions:
- Intrapericardial esmolol effectively suppresses adrenergically induced sinus tachycardia.
- This localized blockade avoids the adverse effects on contractility and blood pressure seen with systemic administration.
- The transatrial approach for intrapericardial drug delivery shows promise for managing tachycardias in patients susceptible to hypotension or with impaired cardiac function.
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