Effect of a single oral dose of pilsicainide on pacing thresholds in pacemaker patients with and without paroxysmal atrial fibrillation.

Abstract

A single oral dose of pilsicainide, a class 1c antiarrhythmic drug, is effective in terminating acute-onset atrial fibrillation (AF), but its effect on pacing thresholds in pacemaker patients is unknown. The present study measured atrial and ventricular pacing thresholds after a single oral dose of pilsicainide in patients with and without AF. Twelve patients with dual-chamber pacemakers were evaluated. Pacing thresholds as well as plasma pilsicainide concentration were measured prior to and then at 30, 60, 90, 120 and 180 min and 24h following a single oral dose of pilsicainide (150 mg). Six patients had paroxysmal AF and the remaining 6 did not. Pacing thresholds increased significantly (134+/-8%) in the atrium (p<0.05) and in the ventricle (155+/-11%; p<0.001) following pilsicainide administration in all 12 patients. Plasma concentrations of pilsicainide showed a positive liner correlation with pacing thresholds (R=0.62, p<0.0001 in the atrium; R=0.74, p<0.0001 in the ventricle). Atrial pacing thresholds in the patients with AF showed a significant increase at 90, 120 and 180 min compared with the patients without AF (p<0.05). There was no significant difference in either the ventricular pacing threshold or the plasma pilsicainide concentration in the patients with and without AF. It was concluded that a single oral dose of pilsicainide increases the pacing thresholds in both the atrium and ventricle in a selected group of pacemaker-implanted patients; that is, those who are aged and with AF. Thus, careful attention should be paid to pacemaker-dependent patients, particularly those with paroxysmal AF, when administering pilsicainide.

• Authors: T Numata, H Abe, T Nagatomo, K Kohshi, Y Nakashima
• Journal: Japanese circulation journal (Jpn Circ J) Vol. 64 Issue 10 Pg. 750-4 (Oct 2000) ISSN: 0047-1828 [Print] Japan
• PMID: 11059614 (Publication Type: Journal Article)

Chemical References

• Anti-Arrhythmia Agents
• Lidocaine
• pilsicainide

Topics

• Administration, Oral
• Aged
• Anti-Arrhythmia Agents (administration & dosage, blood)
• Arrhythmias, Cardiac (therapy)
• Atrial Fibrillation (complications)
• Cardiac Pacing, Artificial
• Drug Evaluation
• Female
• Humans
• Lidocaine (administration & dosage, analogs & derivatives, blood)
• Male
• Pacemaker, Artificial