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Efectos de la digoxina en los cambios agudos inducidos por la fibrilación auricular en la refractividad auricular
C Sticherling1, H Oral, J Horrocks
1Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109-0022, USA.
Circulation
|November 15, 2000
Resumen
La digoxina empeora la refractividad auricular después de episodios de fibrilación auricular (FA), lo que aumenta el riesgo de recurrencia de la FA. Este efecto es probablemente debido a la digoxina.
Área de la Ciencia:
- Electrofisiología cardiovascular electrofisiología cardiovascular.
- Las arritmias cardíacas son arritmias cardíacas.
- Farmacología Farmacología.
Sus antecedentes:
- La fibrilación auricular (FA) acorta el período de refracción efectiva auricular (ERP), aumentando la susceptibilidad a nuevos episodios de FA.
- Los cambios agudos en la refractividad auricular pueden deberse a la sobrecarga de calcio intracelular inducida por taquicardia.
Objetivo del estudio:
- Para investigar si la digoxina, un medicamento que aumenta el calcio intracelular, potencia los efectos agudos de la FA en la refractividad auricular en humanos.
Principales métodos:
- ERP auricular medida en 38 adultos sanos después del bloqueo autónomo, de los cuales 19 recibieron tratamiento con digoxina.
- ERP auricular evaluado en longitudes básicas de ciclo de accionamiento (BDCL) de 350 y 500 ms antes y después de un breve episodio de AF.
- Comparación de los cambios en la ERP después de la FA y la incidencia de episodios secundarios de FA entre digoxina y grupos de control.
Principales resultados:
- La ERP auricular posterior a la FA fue significativamente más corta en ambos grupos en comparación con los valores previos a la FA.
- La reducción de la ERP auricular fue significativamente mayor en el grupo de digoxina que en el grupo de control en ambas BDCL.
- Los episodios secundarios de FA ocurrieron con mayor frecuencia en el grupo de digoxina (32%) en comparación con el grupo de control (16%).
Conclusiones:
- La digoxina aumenta el acortamiento agudo de la refractividad auricular después de los episodios de FA.
- Este aumento por digoxina predispone a los pacientes a la reinducción de la FA, independientemente de los efectos vagotónicos.
- Los hallazgos sugieren que los efectos de la digoxina sobre el calcio intracelular contribuyen a su potencial proarrítmico en la FA.
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