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Atrium-targeted drug delivery through an amiodarone-eluting bilayered patch
Robert W Bolderman1, Peter Bruin, J J Rob Hermans
1Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands. r.bolderman@ctc.unimaas.nl
The Journal of Thoracic and Cardiovascular Surgery
|April 6, 2010
Summary
A novel amiodarone-eluting epicardial patch delivers the drug specifically to the atrium, effectively preventing atrial fibrillation with minimal systemic side effects. This targeted approach offers a promising strategy for high-risk patients.
Area of Science:
- Cardiology
- Biomaterials Science
- Pharmacology
Background:
- Oral and intravenous amiodarone are effective in preventing postoperative atrial fibrillation.
- Significant extracardiac side effects limit amiodarone use to high-risk patients.
- A need exists for targeted drug delivery to reduce amiodarone toxicity.
Purpose of the Study:
- To test the hypothesis that an amiodarone-eluting epicardial patch provides atrium-specific drug delivery.
- To assess if this targeted delivery reduces atrial tachyarrhythmia vulnerability.
- To determine if ventricular and plasma amiodarone concentrations are minimized.
Main Methods:
- Goats received bilayered amiodarone-eluting epicardial patches on the right atrium.
- Electrophysiologic parameters were measured over 1 month.
- Amiodarone levels in plasma and cardiac tissues were quantified.
Main Results:
- Amiodarone concentrations were significantly higher in the right atrium compared to other tissues.
- Atrial effective refractory period and conduction time increased, reducing arrhythmia inducibility.
- Plasma amiodarone levels remained undetectably low.
Conclusions:
- Atrium-specific drug delivery via an amiodarone patch is feasible.
- This method achieves therapeutic atrial drug levels while minimizing systemic exposure.
- Epicardial patches represent a promising strategy to prevent postoperative atrial fibrillation with reduced adverse effects.
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