caa a22 4500 477072747 CHVBK 20180405111431.0 cr unu---uuuuu 170330e19961001xx s 000 0 eng 10.1007/BF00823594 doi (NATIONALLICENCE)springer-10.1007/BF00823594 Electrophysiologic mechanisms of adverse effects of class I antiarrhythmic drugs (cibenzoline, pilsicainide, disopyramide, procainamide) in induction of atrioventricular re-entrant tachycardia [Elektronische Daten] [Akira Fujiki, Masanao Tani, Shigeki Yoshida, Hiroshi Inoue] Summary: We evaluated the electrophysiological mechanisms of adverse effects of class I antiarrhythmic drugs (cibenzoline in seven patients, pilsicainide in two, and disopyramide in two, and procainamide in three) in the induction of orthodromic atrioventricular re-entrant tachycardia (AVRT). In 14 patients (10 males, 4 females; mean age 37±18 years) who had inducible AVRT despite the administration of class I drugs, electrophysiological effects of class I antiarrhythmic drugs were evaluated using programmed electrical stimulation techniques. In 4 out of 6 patients with a manifest accessory pathway, class I drugs induced unidirectional conduction block of the accessory pathway (antegrade conduction block associated with preserved retrograde conduction) and enhanced the induction of AVRT with atrial extrastimulation. In eight patients with a concealed accessory pathway, the outward or inward expansion of the tachycardia induction zone was observed in patients who had greater prolongation of the conduction time than the refractory period of the retrograde accessory pathway after class I drugs. During ventricular extrastimulation, the induction of bundle branch reentry after class I drugs initiated the AVRT in patients with either manifest or concealed accessory pathways. We conclude that the adverse effects of class I drugs are mainly due to induction of unidirectional retrograde conduction of the manifest accessory pathway and the greater prolongation of the retrograde conduction time of the concealed accessory pathway than the refractory period, regardless of the subclassification of class I drugs. Kluwer Academic Publishers, 1996 adverse effects nationallicence atrioventricular reentrant tachycardia nationallicence eibenzoline nationallicence pilsicainide nationallicence disopyramide nationallicence procainamide nationallicence Fujiki Akira Second Department of Internal Medicine, Toyama Medical and Pharmaccutical University, Toyama, Japan aut Tani Masanao Second Department of Internal Medicine, Toyama Medical and Pharmaccutical University, Toyama, Japan aut Yoshida Shigeki Second Department of Internal Medicine, Toyama Medical and Pharmaccutical University, Toyama, Japan aut Inoue Hiroshi Second Department of Internal Medicine, Toyama Medical and Pharmaccutical University, Toyama, Japan aut Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/2(1996-10-01), 159-166 0920-3206 10:2<159 1996 10 10557 https://doi.org/10.1007/BF00823594 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00823594 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fujiki Akira Second Department of Internal Medicine, Toyama Medical and Pharmaccutical University, Toyama, Japan aut NATIONALLICENCE 700 1- Tani Masanao Second Department of Internal Medicine, Toyama Medical and Pharmaccutical University, Toyama, Japan aut NATIONALLICENCE 700 1- Yoshida Shigeki Second Department of Internal Medicine, Toyama Medical and Pharmaccutical University, Toyama, Japan aut NATIONALLICENCE 700 1- Inoue Hiroshi Second Department of Internal Medicine, Toyama Medical and Pharmaccutical University, Toyama, Japan aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/2(1996-10-01), 159-166 0920-3206 10:2<159 1996 10 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer