Can a class III antiarrhythmic drug improve electrical defibrillation efficacy during ventricular fibrillation?
OBJECTIVE
We tested whether a new class III drug (MS-551) administered during ventricular fibrillation (VF) could decrease the defibrillation threshold (DFT) in anesthetized canine hearts.


BACKGROUND
Pretreatment with class III antiarrhythmic agents is known to enhance electrical defibrillation efficacy.


METHODS
In a preliminary study (n = 10), we ascertained the validity of DFT determination by a sequence of incremental defibrillation shocks in a single fibrillation/defibrillation episode. We then compared the DFTs after 130 s of VF with and without administration of MS-551 (2 mg/kg body weight) at 10 s after the onset of VF in 12 open chest dogs and 8 closed chest dogs.


RESULTS
MS-551 decreased the DFT in both experimental models (open chest [mean +/- SD]: from 416 +/- 106 to 318 +/- 92 V, p < 0.05; closed chest: from 714 +/- 75 to 615 +/- 112 V, p < 0.05). The change (delta) in DFT in each heart was inversely correlated with the drug-induced prolongation of VF cycle length before the defibrillation attempt (delta DFT vs. delta VF cycle length 10 s before the first discharge: r = -0.58 and -0.81, p < 0.05).


CONCLUSIONS
MS-551 given after the induction of VF improved defibrillation efficacy. Class III antiarrhythmic agents deserve consideration when VF is resistant to electrical defibrillation during cardiopulmonary resuscitation.
Murakawa
Y
Y
Second Department of Internal Medicine, University of Tokyo, Japan.
Yamashita
T
T
Kanese
Y
Y
Omata
M
M
D000200:Action Potentials; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology* / Q000627:therapeutic use; D004285:Dogs; D004554:Electric Countershock; D006321:Heart / Q000187:drug effects*; D011744:Pyrimidinones / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000188:drug therapy / Q000628:therapy*
D000889:Anti-Arrhythmia Agents; D011744:Pyrimidinones; C076259:nifekalant