[Electrophysiologic basis of the anti-arrhythmic action of amiodarone in man]

The aim of this study was to analyse the effect of an intra-atrial injection of 5 mg/kg of amiodarone on the heart rate, the A-V conducting pathways, and the right atrium and ventricle of 23 patients. By recording the potentials in the bundle of His, it was possible to measure the nodal A-V conduction time (A-H interval) and the conduction time below the bundle of His (H-V interval) during atrial pacemaking. The refractory periods were calculated by the stimulus-test method. The results were subjected to statistical analysis using Student's test. They may be summarised as follows: - slowing of the sinus rhythm; - depressed conduction in the A-V node, but without any effect on the speed of conduction infranodally; - an increase in the atrial effective refractory period; - persistant lengthening of both the effective and the functional refractory periods of the A-V node; - an increase in the relative refractory period in the His-Purkinje system, and in the effective refractory period of the ventricle. These findings throw light on the mechanism of the anti-arrhythmic action of amiodarone in man.