title: Nifekalant Versus Amiodarone in the Treatment of Cardiac Arrest: an Experimental Study in a Swine Model of Prolonged Ventricular Fibrillation.
abstract: OBJECTIVE
  The purpose of the experiment was to compare the effects of nifekalant and amiodarone on the return of spontaneous circulation (ROSC), survival, as well as on the hemodynamic parameters in a swine model of prolonged ventricular fibrillation (VF).
  
  
  METHODS
  After 8 min of untreated VF, bolus doses of epinephrine (adrenaline) and either nifekalant, or amiodarone, or saline (n = 10 per group), were administered after randomization. Cardiopulmonary resuscitation (CPR) was commenced immediately after drug administration and defibrillation was attempted 2 min later. CPR was resumed for another 2 min after each defibrillation attempt and the same dose of adrenaline was given every 4th minute during CPR.
  
  
  RESULTS
  Forty-eight hour survival was significantly higher with nifekalant compared to amiodarone (p < 0.001) and saline (p = 0.02), (9/10 vs. 0/10 vs. 3/10, respectively). Systolic aortic pressure, diastolic aortic pressure and coronary perfusion pressure were significantly higher with nifekalant during CPR and immediate post-resuscitation period (p < 0.05). The animals in the amiodarone group had a slower heart rate at the 1st and 45th min post-ROSC (p < 0.001 and p = 0.006, respectively). The number of electric shocks required for terminating VF, time to ROSC and adrenaline dose were significantly higher with amiodarone compared to nifekalant (p < 0.001).
  
  
  CONCLUSIONS
  Nifekalant showed a more favorable hemodynamic profile and improved survival compared to amiodarone and saline in this swine model.
authors.affiliation: 2nd Department of Internal Medicine, Sismanoglio General Hospital, Athens, Greece. georgekarlis@yahoo.com.|Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece. georgekarlis@yahoo.com.
authors.forename: George
authors.identifier: http://orcid.org/0000-0003-1695-3511
authors.initials: G
authors.lastname: Karlis
authors.affiliation: Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.|2nd Department of Obstetrics and Gynecology, Neonatal Division, Aretaieio Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Iacovidou
authors.affiliation: Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.
authors.forename: Pavlos
authors.initials: P
authors.lastname: Lelovas
authors.affiliation: Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Niforopoulou
authors.affiliation: Experimental-Research Center ELPEN Pharmaceutical, Athens, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Papalois
authors.affiliation: 1st Anesthesiology Clinic, Pain Relief and Palliative Care Unit, Aretaieio Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Siafaka
authors.affiliation: 1st Department of Intensive Care Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: Spyros
authors.initials: S
authors.lastname: Mentzelopoulos
authors.affiliation: Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.|MSc "Cardiopulmonary Resuscitation", National and Kapodistrian University of Athens, Medical School, Athens, Greece.|Midwestern University of Chicago, Chicago, IL, USA.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Xanthos
mesh_terms: D000638:Amiodarone / Q000627:therapeutic use*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D016887:Cardiopulmonary Resuscitation; D004195:Disease Models, Animal; D004554:Electric Countershock; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006323:Heart Arrest / Q000188:drug therapy*; D006339:Heart Rate / Q000187:drug effects; D011744:Pyrimidinones / Q000627:therapeutic use*; D016019:Survival Analysis; D013552:Swine; D014693:Ventricular Fibrillation / Q000188:drug therapy*
chemical_list: D011744:Pyrimidinones; C076259:nifekalant; D000638:Amiodarone; D004837:Epinephrine
keywords: Amiodarone; Antiarrhythmic drug; Arrhythmia; Cardiac arrest; Cardiopulmonary resuscitation; Nifekalant