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Shvoong Home>Medicine & Health>Effects of mexiletine on transmural dispersion of repolarization of left anterior ventricular wall i Review

Effects of mexiletine on transmural dispersion of repolarization of left anterior ventricular wall i

Article Review   by:TsingHua     Original Author: Journal of Clinical Cardiology
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Objective:To investigate the changes of action potential duration(APD) and transmural dispersion of repolarization(TDR) in Canine model of long-QT syndrome type 3(LQT3) in vivo during bradycardia, to explore the the impact of the sodium channel block-mexiletine on this changes, and to provide experimental evidence for the prevention and treatment of ventricular arrhythemia in congenital LQT3. Methord: The monophasic action potentials(MAP) of endocardium, mid-myocardium and epicardium at the anterior ventricular wall were recorded synchronously in vivo by a self-made electrode, sea anemone toxin (ATX-Ⅱ ) was administered intravenously to mimic LQT3 model, the heart rate was controlled by altering atrium pacing cycle length(PCL) after the sinoatrial node been ablated by 40% formaldehyde. Result:The LQT3 model had been made successfully by the intravenous injection of ATX-Ⅱ (3 μg/kg). The TDR had been increased remarkably by the ATX-Ⅱ when the PCL was both 500 ms and 1000 ms (20±4 ms vs 41 ± 9 ms and 39±5 ms vs 83 ±10 ms respectively, P <0. 05), but the net increase of TDR(ⅡTDR) was more remarkable when the PCL was 1000 ms compared to 500 ms (44±13 ms vs 20± 12 ms, P <0. 05) , with the occurrence of early after depolarization(EAD) originated from mid-myocardium and spontaneity ventricular tachycardia. This electrophysiological effect of ATX-Ⅱ could be reversed by mexiletine(20 μg/kg). Conclusion:The occurrence of ventricular tachycardia in LQT3 model is bradycardia dependent, Mexiletine is probably an effective medicine in the prevention and treatment of the sudden cardiac death of congenital LQT3.
Published: May 25, 2006   
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