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Updated: Jul 18, 2026
08:56
Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
Published on: September 24, 2021
Pilsicainide for atrial fibrillation.
Koichiro Kumagai1, Hideko Nakashima, Hideaki Tojo
1Department of Cardiology, University Hospital of Fukuoka, 7-45-1 Nanajuma, Jonan-ku, Fukuoka 814-0180, Japan. kxk@fukuoka-u.ac.jp
Drugs
|November 23, 2006
Summary
Pilsicainide, a sodium channel blocker, prolongs atrial refractory periods and impairs pulmonary vein (PV) to left atrium (LA) conduction. This drug may help isolate PVs, offering a new approach for atrial fibrillation (AF) treatment.
Area of Science:
- Cardiology
- Pharmacology
- Electrophysiology
Background:
- Pilsicainide is a Class IC antiarrhythmic drug.
- It exhibits pure sodium channel blockade with slow recovery kinetics.
- Experimental studies show it depresses intra-atrial conduction and prolongs atrial effective refractory period (ERP).
Purpose of the Study:
- To investigate the effects of pilsicainide on atrial electrophysiology in patients with paroxysmal atrial fibrillation (AF).
- To explore the potential of pilsicainide in achieving pulmonary vein (PV) isolation.
- To evaluate pilsicainide's role in AF management, including hybrid therapies.
Main Methods:
- Electrophysiological studies in patients with paroxysmal AF.
- Measurement of atrial effective refractory period (ERP) in the PV, PV-left atrium (LA) junction, and LA.
- Assessment of conduction time from distal PV to PV-LA junction.
- Observation of PV-LA conduction block during pilsicainide administration.
Main Results:
- Pilsicainide significantly prolonged ERP in the PV, PV-LA junction, and LA.
- Conduction time from distal PV to PV-LA junction was increased.
- PV-LA conduction block was observed in some patients prior to pilsicainide-induced AF termination.
- Pharmacological PV isolation by pilsicainide was suggested as a mechanism for AF conversion.
Conclusions:
- Pilsicainide effectively prolongs atrial refractoriness and impairs PV-LA conduction.
- Pharmacological PV isolation by pilsicainide may be a novel mechanism for AF termination.
- Hybrid therapy combining pilsicainide with radiofrequency catheter ablation shows promise for AF treatment.
- Pilsicainide may prevent AF development post-ablation by suppressing focal atrial discharges.
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