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Cibenzoline transforms random re-entry into ordered re-entry in the atria
European Heart Journal
|February 1, 1993
Summary
Cibenzoline, a class I drug, converts atrial fibrillation to atrial tachycardia by slowing conduction. This antiarrhythmic effect transforms chaotic electrical activity into organized re-entry pathways in the atria.
Area of Science:
- Cardiology
- Electrophysiology
- Pharmacology
Background:
- Atrial fibrillation (AF) is a complex arrhythmia.
- Class I antiarrhythmic drugs are known to affect cardiac electrophysiology.
- Understanding the substrate of AF is crucial for developing effective treatments.
Purpose of the Study:
- To test if class I drugs modify the electrophysiological substrate of atrial fibrillation.
- To investigate the effects of cibenzoline on atrial activation patterns in patients with AF.
Main Methods:
- Electrophysiological study in 20 patients with spontaneous or induced AF.
- High-resolution epicardial mapping (248 channels) before and after cibenzoline administration.
- Intra-operative mapping in one patient undergoing a 'corridor' operation.
Main Results:
- Cibenzoline converted AF to regular monomorphic atrial tachycardia in 18/20 patients.
- Mean atrial cycle length significantly prolonged from 147 ms to 302 ms (P < 0.001).
- Sinus rhythm was restored in 8/18 patients; mapping showed fusion of wavelets into ordered re-entry.
Conclusions:
- Cibenzoline transforms random re-entry into ordered re-entry in the atria.
- This effect is likely due to the drug's depression of atrial conduction.
- Cibenzoline demonstrates potential as an antiarrhythmic agent for AF management.
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