Antazoline is a first-generation antihistaminic agent with additional anticholinergic properties and antiarrhythmic potential. Recent data shows its high effectiveness in sinus rhythm restoration among patients with paroxysmal atrial fibrillation. The effect of antazoline on electrophysiological parameters of the heart in vivo has not yet been examined. The aim of this study was to evaluate changes in electrophysiological parameters of the heart muscle and conduction system as a response to increasing doses of antazoline.
After successful ablation of supraventricular arrhythmias, the electrophysiological parameters: sinus rhythm cycle length (SRCL), AH, HV, QRS, QT, QTc intervals, Wenckebach point (WP), sinus node recovery period (SNRT), intra- (hRA-CSos) and interatrial conduction time (hRA-CSd), right and left atrium refractory period (RA-; LA-ERP), and atrioventricular node refractory period (AVN-ERP) were assessed initially and after 100, 200, and 300 mg of antazoline given intravenously.
Fifteen patients (8 males, 19–72 years old) undergoing EPS and RF ablation were enrolled. After 100 mg bolus, a significant reduction in SRCL was noticed. After antazoline administration, significant prolongation of HV, QRS, QTc, hRA-CSos, hRA-CSd intervals, RA– and LA-ERP and reduction of SRCL were observed. After a total dose of 300 mg, QT interval prolonged significantly. Increasing the dose of antazoline had no impact on AH, Wenckebach point, AVN-ERP, and SNRT.
Antazoline has an effect on electrophysiological parameters of the atrial muscle and has rapid onset of action. No negative effect on sinus node function and atrioventricular conduction in a unique property among antiarrhythmic drugs.
Heinberg CJ. A new synthetic anti-histaminic substance, antistine. Eye Ear Nose Throat Mon. 1947;26:639–41. PubMed
McKechnie JK. The cardiac action of the antihistamine compounds. S Afr Med J. 1952;26:609–13. PubMed
Angelakos ET, Hegnauer AH. Pharmacological agents for the control of spontaneous ventricular fibrillation under progressive hypothermia. J Pharmacol Exp Ther. 1959;127:137–45. PubMed
Dreifus LS, McGarry TF, Watanabe Y. Clinical and physiological effect of antazoline, a new antiarrhythmic agent. American Heart Journal. 1963;65:607–14. CrossRef
Kuch M, Janiszewski M, Dluzniewski M, et al. Antazoline—ineffective or misprized in the treatment of paroxysmal atrial fibrillation? Pol J Cardiol. 2000;3:247–51.
Farkowski MM, Maciąg A, Zurawska M, et al. Comparative effectiveness and safety of antazoline-based and propafenone-based strategies for pharmacological cardioversion of short-duration atrial fibrillation in the emergency department. Pol Arch Med Wewn. 2016;126:381–7. PubMed
Piotrowski R, Giebultowicz J, Baran J et al. Antazoline-insights into drug-induced electrocardiographic and hemodynamic effects: Results of the ELEPHANT II substudy. Ann Noninvasive Electrocardiol 2017 25.
- Effect of Antazoline on Electrophysiological Properties of Atrial Muscle and Conduction System of the Heart
Bartłomiej Jacek Bińkowski
- Springer US
Neu im Fachgebiet Kardiologie
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