Detection of Proarrhythmia in the Female Rabbit Heart:
- 1 March 2003
- journal article
- research article
- Published by Wiley in Journal of Cardiovascular Electrophysiology
- Vol. 14 (3) , 287-294
- https://doi.org/10.1046/j.1540-8167.2003.02466.x
Abstract
Reliable detection of drug-induced proarrhythmia, especially the potential for polymorphic ventricular tachycardia, is of great importance in the development of new compounds that are safe for the heart and was evaluated in a blinded study. In 142 female rabbits, the monophasic action potential was used to determine intraventricular conduction, action potential duration (APD), triangulation (APD30 to APD90), reverse use-dependence, instability and presence of chaotic behavior, early afterdepolarizations, torsades de pointes (TdP), and ventricular fibrillation. In addition, 31 coded drugs were tested in a blinded fashion in another 150 hearts. Prototype cardiovascular agents [quinidine (IA), lidocaine (IB), flecainide (IC), propranolol (II), sotalol (IIIB), amiodarone (IIIAB) and verapamil (IV)] were correctly characterized in terms of their effects upon conduction and APD. Agents documented in clinical practice to have proarrhythmic potential (droperidol, sotalol, mibefradil, bepridil, lidoflazine, ketanserin, sertindole, terfenadine, haloperidol, astemizole, cisapride, ziprasidone, lubeluzole, dofetilide, quinidine, ibutilide) were identified as such. Pimozide is reported to rarely produce TdP and was also found to elicit Class III action with few adverse effects. Equally important, agents believed not to be proarrhythmic (two solvents, atenolol, propranolol, fenoximone, cetirizine, verapamil, sildenafil, lidocaine, diltiazem) were identified as having no proarrhythmic activity. The SCREENIT method properly characterized and quantified prototype cardiovascular drugs and correctly identified proarrhythmic noncardiovascular agents of various mechanisms, but it did not produce false-positive results.Keywords
This publication has 53 references indexed in Scilit:
- High affinity interaction of mibefradil with voltage‐gated calcium and sodium channelsBritish Journal of Pharmacology, 2000
- Antiarrhythmic Actions of Amiodarone: A Profile of a Paradoxical AgentThe American Journal of Cardiology, 1996
- Effects of the Antihypoxic and Neuroprotective Drug, Lubeluzole, on Repolarization Phase of Canine Heart Assessed by Monophasic Action Potential RecordingToxicology and Applied Pharmacology, 1996
- Reversible QT Prolongation With Torsades De Pointes in a Patient With Pimozide IntoxicationThe Lancet Healthy Longevity, 1995
- Survival with oral d-Sotalol in patients with left ventricular dysfunction after myocardial infarction: Rationale, design, and methods (the SWORD trial)The American Journal of Cardiology, 1995
- In vitroelectrophysiological detection of iatrogenic arrhythmogenicityFundamental & Clinical Pharmacology, 1994
- Lack of Triggered Automaticity Despite Repolarization Abnormalities due to Bepridil and LidoflazinePacing and Clinical Electrophysiology, 1990
- Rate-dependent changes in excitability of depressed cardiac Purkinje fibers as a mechanism of intermittent bundle branch block.Circulation, 1983
- Electrophysiology and pharmacology of cardiac arrhythmias. II. Relationship of normal and abnormal electrical activity of cardiac fibers to the genesis of arrhythmiasAmerican Heart Journal, 1974
- Influence of lidoflazine on cardiac transmembrane potentials and experimental arrhythmiasNaunyn-Schmiedebergs Archiv für experimentelle Pathologie und Pharmakologie, 1971