The Rise Time of the Monophasic Action Potential : A New Index of Loca Use-Dependent Conductivity by Sodium Channel Blockers in Human Myocardium
スポンサーリンク
概要
- 論文の詳細を見る
The kinetics of global use-dependent conduction slowing produced by sodium channel blockers in the human heart, estimated as a change in the QRS width, are known to be similar to those of use-dependent block of the maximum rate of depolarization in in vitro studies. However, the kinetics of the regional use-dependent decrease in conductivity have not been investigated. We examined whether the rise time of the monophasic action potential would be clinically useful as a marker of the local use-dependent decrease in conductivity by sodium channel blockers. In 12 patients without organic heart disease, monophasic action potentials (MAPs) were recorded at the right ventricular endocardium using a contact electrode before and after the administration of disopyramide (n:6, 2 mg/kg, iv) or pilsicainide (class Ic agents, n=4, 1 mg/kg, iv, and n=2, 150 mg, po) while the stimulus frequency was abruptly increased from 100/min to 150/min. The rise time, defined as the interval from the pacing pulse to the first peak deflection of the monophasic action potential, and the QRS width were measured simultaneously. In the absence of the sodium channel blockers, the abrupt increase in heart rate did not alter the QRS width or the rise time. In the presence of the agents, both variables were lengthened exponentially. The rate constants of onset changes in the QRS width and the rise time were 2.1±0.5 beats and 2.1±0.4 beats after the administration of disopyramide, and 7.5±3.0 beats and 8.2±4.0 beats after pilsicainide, respectively. The rate constant of the rise time was closely correlated with that of the QRS width. The present results are very closely comparable with the onset rate constants of use-dependent block of the maximum rate of depolarization in in vitro studies. These results suggest that (1) the rise time is a good indicator of local use-dependent decrease in conductivity by sodium channel blockers in human hearts and (2) the local use-dependent decrease in conductivity has kinetics similar to those of use-dependent sodium channel blocks.
- 社団法人日本循環器学会の論文
- 1997-11-20
著者
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Iwabuchi Kaoru
Department Of Cardiology Osaki City Hospital
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Baba Shigeo
Department of Cardiovascular Medicine, Graduate School of Medicine Tohoku University
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Satoh Shoichi
Department of Internal Medicine, Kamaishi City Hospital
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Miura Masahito
Tohoku University School Of Health Science
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Shirato Kunio
First department of Internal Medicine, Tohoku University School of Medicine
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Baba Shigeo
Department Of Cardiovascular Medicine Graduate School Of Medicine Tohoku University
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Satoh S
Department Of Internal Medicine Kamaishi City Hospital
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Satoh Syoichi
The First Department Of Internal Medicine Tohoku University
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Satoh Shoichi
X Ray Research Laboratory Rigaku Corporation
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Ishide Nobumasa
Miyagi Study Group of Acute Myocardial Infarction(Miyagi-Ken Shinkin Kousoku Taisaku Kyogikai)
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Shinozaki Tsuyoshi
First Department of Internal Medicine, Tohoku University School of Medicine
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Miura Masahito
First Department of Internal Medicine, Tohoku University School of Medicine
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Iwabuchi Kaoru
First Department of Internal Medicine, Tohoku University School of Medicine
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Takeuchi Masaharu
First Department of Internal Medicine, Tohoku University School of Medicine
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Suzuki Shu
First Department of Internal Medicine, Tohoku University School of Medicine
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Baba Shigeo
First Department of Internal Medicine, Tohoku University School of Medicine
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Katoh Hiroshi
First Department of Internal Medicine, Tohoku University School of Medicine
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Funakoshi Masayuki
First Department of Internal Medicine, Tohoku University School of Medicine
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Keitoku Mitsumasa
First Department of Internal Medicine, Tohoku University School of Medicine
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Watanabe Jun
First Department of Internal Medicine, Tohoku University School of Medicine
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Ishide Nobumasa
Department of Cardiovascular Medicine, Sendai Tokusyukai Hospital
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Miura Masahito
The First Department Of Internal Medicine Tohoku University School Of Medicine
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Keitoku Mitsumasa
The First Department of Internal Medicine Tohoku University School of Medicine
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Satoh Syoichi
The 1st Dept. Of Internal Medicine Tohoku University School Of Medicine
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Satoh Shoichi
Department Of Internal Medicine Kamaishi City Hospital
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Keitoku Mitsumasa
Department Of Cardiology Tohoku Kosai Hospital
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Shirato Kunio
First Department Of Internal Medicine Tohoku University School Of Medicine
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Suzuki Shu
First Department Of Internal Medicine Tohoku University School Of Medicine
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Miura Masaetsu
Department Of Cardiovascular Medicine Tohoku University Graduate School Of Medicine
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Sato Sotaro
The First Dep. Of Int. Med. Tohoku Univ. School Of Medicine Sendai
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Keitoku Mitsumasa
The First Department Of Internal Medicine Tohoku University
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Keitoku Mitsurnasa
The First Department Of Internal Medicine Tohoku University School Of Medicine
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Ishide Nobumasa
The 1st.department Of Internal Medicine Tohoku University School Of Medicine
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Miura Masahito
Department Of Cardiology Tohoku University
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Takeuchi Masaharu
First Department Of Internal Medicine Tohoku University School Of Medicine
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Ishida Nobumasa
The First Department Of Internal Medicine Tohoku University School Of Medicine
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Funakoshi Masayuki
First Department Of Internal Medicine Tohoku University School Of Medicine
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Ishide Nobumasa
東北大学
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Keitoku Mitsumasa
First Department Of Internal Medicine Tohoku University School Of Medicine
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Miura Masaetsu
Department Of Internal Medicine Furukawa City Hospital
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Matsuzaki Masunori
Departments Of Cardiovascular Medicine And Evidence-based Cardiovascular Medicine Tohoku University
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Miura Masanobu
Departments Of Cardiovascular Medicine And Evidence-based Cardiovascular Medicine Tohoku University
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Kato Ichiro
Department Of Biochemistry Scool Of Medicine Toyama Medical And Pharmaceutical University
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