Comparative antiarrhythmic efficacy of amiodarone and dronedarone during acute myocardial infarction in rats

Eur J Pharmacol. 2007 Jun 14;564(1-3):150-7. doi: 10.1016/j.ejphar.2007.02.052. Epub 2007 Mar 7.

Abstract

The effects of dronedarone, a non-iodinated derivative of amiodarone, on ventricular tachycardia and ventricular fibrillation post-myocardial infarction are not well established. Fifty-five Wistar rats were randomly allocated to a 2-week oral treatment with either vehicle (n=18), amiodarone (30 mg/kg, n=20), or dronedarone (30 mg/kg, n=17). After acute coronary artery ligation, a single-lead electrocardiogram was continuously recorded for 24 h and episodes of ventricular tachycardia/fibrillation as well as mortality rates were analysed. Monophasic action potential recordings were obtained from the left ventricular epicardium at baseline and 24 h post-myocardial infarction. Thyroid hormones and catecholamines were measured using radioimmunoassay. Thyroid function was similar in the 3 groups. Compared to controls, amiodarone and dronedarone equally decreased the number of ventricular tachycardia/fibrillation episodes by approximately 75%. Both agents prevented the increase in monophasic action potential duration and in beat-to-beat variation. Norepinephrine levels were lower only after amiodarone treatment. Despite the observed antiarrhythmic effect, total mortality did not differ between groups (38.8% in controls, 30.0% in the amiodarone group and 58.8% in the dronedarone group), because of excess bradyarrhythmic mortality in both drug groups that reached significance in the dronedarone group. Dronedarone and amiodarone display similar antiarrhythmic efficacy post-myocardial infarction, partly by preventing repolarization inhomogeneity. However, dronedarone increases bradyarrhythmic mortality possibly secondary to its negative inotropic effects.

Publication types

  • Comparative Study

MeSH terms

  • Action Potentials / drug effects
  • Amiodarone / analogs & derivatives*
  • Amiodarone / pharmacology
  • Amiodarone / therapeutic use*
  • Animals
  • Anti-Arrhythmia Agents / pharmacology
  • Anti-Arrhythmia Agents / therapeutic use*
  • Disease Models, Animal
  • Dronedarone
  • Electrocardiography, Ambulatory
  • Epinephrine / metabolism
  • Female
  • Myocardial Infarction / complications
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / mortality
  • Norepinephrine / metabolism
  • Radioimmunoassay
  • Random Allocation
  • Rats
  • Rats, Wistar
  • Tachycardia, Ventricular / drug therapy
  • Telemetry
  • Thyroid Hormones / metabolism
  • Ventricular Fibrillation / drug therapy

Substances

  • Anti-Arrhythmia Agents
  • Thyroid Hormones
  • Dronedarone
  • Amiodarone
  • Norepinephrine
  • Epinephrine