ST segment elevation induced by class IC antiarrhythmic agents: Underlying electrophysiologic mechanisms and insights into drug-induced proarrhythmia

Journal of Cardiovascular Electrophysiology

Volumn 9, Issue 11, 1998, Pages 1167-1172

  Krishnan, Subramaniam C ^a   Josephson, Mark E ^a  

^a BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

Author keywords

Encainide; Flecainide; Proarrhythmia; ST segment elevation

Indexed keywords

AMIODARONE; ANTIARRHYTHMIC AGENT; ATENOLOL; ENCAINIDE; FLECAINIDE; SODIUM CHANNEL; VERAPAMIL;

ADULT; ARTICLE; CALCIUM CURRENT; CASE REPORT; DRUG WITHDRAWAL; ELECTROPHYSIOLOGY; EXERCISE TEST; HEART ARRHYTHMIA; HEART ATRIUM FIBRILLATION; HEART RIGHT BUNDLE BRANCH BLOCK; HEART VENTRICLE FIBRILLATION; HEART VENTRICLE TACHYCARDIA; HUMAN; MALE; PATHOPHYSIOLOGY; PRIORITY JOURNAL; ST SEGMENT ELEVATION;

EID: 0031795404     PISSN: 10453873     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1540-8167.1998.tb00088.x     Document Type: Article

References (17)

1. Miyazaki T, Mitamura H, Miyoshi S, et al: Autonomic and antiarrhythmic drug modulation of ST segment elevation in patients with Brugada syndrome. J Am Coll Cardiol 1996;27:1061-1070.
2. 3 in patients with idiopathic ventricular fibrillation. (Abstract) PACE 1996;19:599.
3. 3. A marker for sudden death in patients without demonstrable structural heart disease. Circulation 1998;97:457-460.
4. Chen Q, Kirsch G, Zhang D, et al: Genetic and molecular mechanisms for idiopathic ventricular fibrillation. Nature 1998;392:293-296.
5. Krishnan S, Antzelevitch C: Sodium channel block produces opposite electrophysiologic effects across the ventricular wall. Circ Res 1991;69:277-291.
6. Krishnan S, Antzelevitch C: Flecainide-induced arrhythmia in canine ventricular epicardium: Phase 2 reentry? Circulation 1993;87:562-572.
7. Antzelevitch C, Sicouri S, Litovsky S, et al: Heterogeneity within the ventricular wall: Electrophysiology and pharmacology of epicardial, endocardial and M cells. Circ Res 1991;69:1427-1449.
8. DiDiego JM, Sicouri S, Litovsky S, et al: Two components of the transient outward current in canine ventricular epicardium: Right versus left. Circulation 1991;84:II-179.
9. 10 and action potential notch are smaller in left vs right canine ventricular epicardium. Am J Physiol 1996;271:H548-H561.
10. K by flecainide and E-4031 in cat ventricular myocytes. Circulation 1990;82:289-293.
11. Wang Z, Pelletier LC, Talajic M, et al: The effects of flecainide and quinidine on human atrial action potentials: Role of rate dependence and comparison with guinea pig. rabbit, and dog tissues. Circulation 1990;82:278-283.
12. Wagner G: Marriot's Practical Electrocardiography. Ninth Edition. Williams & Wilkins, Baltimore, 1994.
13. Brugada P, Brugada J: Right bundle branch block, persistent ST segment elevation and sudden cardiac death: A distinct clinical and electrocardiographic syndrome. J Am Coll Cardiol 1992;20:1391-1396.
14. CAST Investigators: Preliminary report: Effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989;321:406-412.
15. Anastasiou-Nana M, Anderson JL, Stewart JR, et al: Occurrence of exercise-induced and spontaneous wide complex tachycardia during therapy with flecainide for complex ventricular arrhythmias: A probable proarrhythmic effect. Am Heart J 1987;113:1071-1077.
16. Ranger S, Talajic M, Lemery R, et al: Amplification of flecainide-induced ventricular conduction slowing by exercise: A potentially significant clinical consequence of use-dependent sodium channel blockade. Circulation 1988;79:1000-1006.
17. Anno T, Hondeghem LM: Interactions of flecainide with guinea pig cardiac sodium channels: Importance of activation unblocking to the voltage dependence of recovery. Circ Res 1990;66:789-803.