Digoxin delays recovery from tachycardia-induced electrical remodeling of the atria

Digoxin delays recovery from tachycardia-induced electrical remodeling of the atria

Atrial fibrillation (AF) induces electrical remodeling, which is thought to be responsible for the low success rate of antiarrhythmic treatment in AF of longer duration. Electrical remodeling seems to be related to tachycardia-induced intracellular calcium overload. Due to its vagomimetic action, di...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) Vol. 100; no. 17; pp. 1836 - 1842
Main Authors: TIELEMAN, R. G, BLAAUW, Y, VAN GELDER, I. C, DE LANGEN, C. D. J, DE KAM, P. J, GRANDJEAN, J. G, PATHERG, K. W, BEL, K. J, ALLESSIE, M. A, CRIJNS, H. J. G. M
Format: Journal Article
Language:English
Published: Hagerstown, MD Lippincott Williams & Wilkins 26-10-1999
American Heart Association, Inc
Subjects:
Animals
Anti-Arrhythmia Agents - pharmacology
Aortic Bodies - drug effects
Atrial Fibrillation - physiopathology
Atrial Function - drug effects
Biological and medical sciences
Cardiac dysrhythmias
Cardiology. Vascular system
Digoxin - pharmacology
Electrophysiology
Goats
Heart
Heart Rate
Medical sciences
Refractory Period, Electrophysiological
Tachycardia, Ectopic Atrial - physiopathology
Heart
Pharmacologic test
Atrium
Arrhythmia
Digoxin
Atrial fibrillation
Electrical stimulus
Electrophysiology
Cardiovascular disease
Antiarrhythmic agent
Excitability disorder
Vertebrata
Mammalia
Heart disease
Animal
Refractory period
Goat
Glycoside
Artiodactyla
Ungulata
Digitalis drug
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Summary:Atrial fibrillation (AF) induces electrical remodeling, which is thought to be responsible for the low success rate of antiarrhythmic treatment in AF of longer duration. Electrical remodeling seems to be related to tachycardia-induced intracellular calcium overload. Due to its vagomimetic action, digoxin is widely used to control the ventricular rate during AF, but it also increases intracellular calcium. On the basis of these characteristics, we hypothesized that digoxin would aggravate tachycardia-induced electrical remodeling. We analyzed the atrial effective refractory period (AERP) at cycle lengths of 430, 300, and 200 ms during 24 hours of rapid atrio/ventricular (300/150 bpm) pacing in 7 chronically instrumented conscious goats treated with digoxin or saline. Digoxin decreased the spontaneous heart rate but had no other effects on baseline electrophysiological characteristics. In addition to a moderate increase in the rate of electrical remodeling during rapid pacing, digoxin significantly delayed the recovery from electrical remodeling after cessation of pacing (at 430, 300, and 200 ms: P=0. 001, P=0.0015, and P=0.007, respectively). This was paralleled by an increased inducibility and duration of AF during digoxin. Multivariate analysis revealed that both a short AERP and treatment with digoxin were independent predictors of inducibility (P=0.001 and P=0.03, respectively) and duration (P=0.001 for both) of AF. Dioxin aggravates tachycardia-induced atrial electrical remodeling and delays recovery from electrical remodeling in the goat, which increases the inducibility and duration of AF.
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ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.100.17.1836