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In Vitro Effects of Acute Amiodarone and Dronedarone on Epicardial, Endocardial, and M Cells of the Canine Ventricle

Laboratorio de Electrofisiología Celular División Cardiología, Hospital Ramos Mejía, Buenos Aires, Argentina

Marcela Ferreiro, MD

Laboratorio de Electrofisiología Celular División Cardiología, Hospital Ramos Mejía, Buenos Aires, Argentina

Daniela Celestino, BS

Laboratorio de Electrofisiología Celular División Cardiología, Hospital Ramos Mejía, Buenos Aires, Argentina

Emiliano Medei, MD

Laboratorio de Electrofisiología Celular División Cardiología, Hospital Ramos Mejía, Buenos Aires, Argentina

Marcelo V. Elizari, MD

Laboratorio de Electrofisiología Celular División Cardiología, Hospital Ramos Mejía, Buenos Aires, Argentina

Serge Sicouri, MD

Laboratorio de Electrofisiología Celular División Cardiología, Hospital Ramos Mejía, Buenos Aires, Argentina, sicouris{at}mmrl.edu

Amiodarone (AM) is an antiarrhythmic agent widely used in the treatment of ventricular and supraventricular arrhythmias. Dronedarone (DR) is a new compound with a pharmacological profile similar to that of AM, but iodine free. We previously demonstrated that chronic AM treatment reduces transmural dispersion of repolarization (TDR) in the canine heart. We used standard microelectrode technique to evaluate the effects of acute AM (100 µM) and DR (30 µM) on epicardial (EPI), endocardial (ENDO), and M region tissues obtained from the left ventricular wall of the canine heart. Amiodarone (100 µM, 120 min of exposure) produced little change in the action potential duration of ENDO and EPI tissues, but it shortened the action potential of M cells, especially at slow rates, leading to a decrease in TDR. Similar results were observed with DR. Acute AM (100 µM) and DR (30 µM) eliminated d-sotalol—induced early afterdepolarizations (EADs) and triggered activity in 3 of 3 and 2 of 6 M cell preparations, respectively. The reduction of TDR and the elimination of EAD-induced triggered activity differentiates AM and DR from other class III agents. These effects may explain the efficacy and low arrhythmogenicity of acute AM and suggest a potential safe use of DR as an antiarrhythmic agent.

Key Words: antiarrhythmic drugs • transmural dispersion of repolarization • early afterdepolarizations

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