Topical application of a biodegradable disc with amiodarone for atrial fibrillation
Topical application of a biodegradable disc with amiodarone for atrial fibrillation
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局部应用可生物降解的椎间盘与胺碘酮治疗心房颤动
DOI：
10.1016/j.athoracsur.2010.10.022
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发表时间：
2011
期刊：
影响因子：
4.6
通讯作者：
et al
中科院分区：
文献类型：
--
作者：
Takeda T;et al
胺碘酮是一种有效的抗心房颤动（AF）药物;然而，其全身给药会引起严重的副作用，如间质性肺炎。为避免这些副作用，我们研制了胺碘酮的局部缓释系统。在全身麻醉下，日本白色家兔进行正中胸骨切开术，将含或不含胺碘酮（30 mg）的生物可降解圆盘植入右心房表面。植入后3天，我们使用Langendorff装置测量组织胺碘酮浓度（n = 5）、AF阈值和左心房的心房有效不应期。右心房的胺碘酮浓度远高于肺、心室及其他器官（P < 0.01）。胺碘酮的血药浓度低于可检测水平。胺碘酮可生物降解圆盘显著提高AF阈值（胺碘酮组，6.9 ± 4.6 mA vs对照组，0.5 ± 0.6 mA; p < 0.01）和有效不应期胺碘酮组53.9 ± 8.9毫秒，对照组43.9 ± 9.5毫秒; p = 0.035），表明胺碘酮生物可降解盘对左心房的电生理学作用。此外，胺碘酮组发生AF的可能性明显低于对照组（p < 0.01）。结论：这种方法可能是预防术后AF的一种侵入性较小且有效的治疗选择。
BACKGROUNDAmiodarone is a potent anti-atrial fibrillation (AF) agent; however, its systemic administration induces serious side effects such as interstitial pneumonia. To avoid such effects, we developed a local sustained-release system for amiodarone.METHODSA biodegradable, cross-linkable dextran disc was developed as a sustained-release carrier for amiodarone. Under general anesthesia, Japanese white rabbits underwent median sternotomy and the biodegradable disc with or without amiodarone (30 mg) was implanted onto the surface of the right atrium. Three days after implantation, we measured tissue amiodarone concentrations (n = 5), the AF threshold, and the atrial effective refractory period of the left atrium by using the Langendorff apparatus. The incidences of induced AF evoked by rapid pacing were measured and compared.RESULTSThe right atrial concentration of amiodarone was far higher than that in the lungs, ventricles, or other organs (p < 0.01). The blood concentration of amiodarone was below detectable levels. The amiodarone biodegradable disc significantly increased the AF threshold (amiodarone group, 6.9 ± 4.6 mA versus control group, 0.5 ± 0.6 mA; p < 0.01) and the effective refractory period (amiodarone group, 53.9 ± 8.9 milliseconds versus control group, 43.9 ± 9.5 milliseconds; p = 0.035) of the left atrium, indicating the electrophysiologic effect of the amiodarone biodegradable disc on the left atrium. Further, the amiodarone group was significantly less likely to experience AF, as compared with the control group (p < 0.01).CONCLUSIONSThis approach may be a less invasive and effective therapeutic option for preventing postoperative AF.