Effect of parenteral d-sotalol on transvenous atrial defibrillation threshold in a canine model of atrial fibrillation

D. Iskos, K. G. Lurie, S. W. Adler, J. J. Shultz, P. R. Coffeen, K. A. Mulligan, D. G. Benditt

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14 Scopus citations

Abstract

In an effort to reduce energy requirements for atrial defibrillation to a level low enough to perform painless electrical cardioversion with an implantable atrial defibrillator, we tested the hypothesis that drug therapy with the class III agent d-sotalol, when used concurrently with a low-energy shock, reduces atrial defibrillation threshold. In a nonthoracotomy canine model of atrial fibrillation, intracardiac shocks were delivered between the distal coronary sinus and the mid-right atrium. Based on a step-up energy delivery protocol the atrial defibrillation threshold was defined as the least amount of energy that resulted in a >10% and <90% rate of successful defibrillation. At a dose associated with class III antiarrhythmic effects (5 mg/kg), d-sotalol significantly reduced atrial defibrillation threshold from 1.72 ± 1.12 J to 0.59 ± 0.60 J (p < 0.01). These results support the feasibility of using antiarrhythmic drug therapy with d-sotalol to minImize energy requirements for intracardiac electrical cardioversion of atrial fibrillation.

Original languageEnglish (US)
Pages (from-to)116-119
Number of pages4
JournalAmerican Heart Journal
Volume132
Issue number1 I
DOIs
StatePublished - Jan 1 1996

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