Abstract
ABSTRACT: Transmembrane recordings and surface electrograms were used to evaluate the influence of propafenone on the cellular electrophysiology of isolated neonatal and adult rabbit atrioventricular node (AVN) preparations. An automatic interval of 863 ± 82 ms (mean ± SEM, n = 14) in neonates was found to be significantly shorter than the 1510− ± 205-ms (n = 12) automatic interval observed in adults. Propafenone in a concentration of 5 × 10-6 M significantly increased the automatic interval of neonatal pacemakers but not that of the adult preparations. These changes in automaticity produced by propafenone were not dependent on the adrenergic receptor-blocking action of the drug. The pacemaker escape time after overdrive pacing was also shorter in the neonate than in the adult. Propafenone prolonged the escape time of the neonatal tissues but not those of the adult. AVN refractory period, A-H interval, and antegrade Wenckebach rate were comparably increased in a concentration-dependent manner in both age groups. The maximum diastolic potential was decreased by propafenone in the neonatal atrionodal tissue but not in other regions of the AVN and not in any region of the adult AVN. Action-potential duration was increased in all regions of the AVN in both age groups. Action-potential amplitude and maximum upstroke velocity were decreased by propafenone in both age groups. Unlike other excitable tissues of the heart, the action-potential duration of AVN nodal cells increased with decreasing pacing intervals as the pacing interval approached the Wenckebach interval. This increase in action-potential duration was enhanced by propafenone and may be a major factor in the drug-dependent increase in the Wenckebach interval. These results may provide a partial explanation for the putative efficacy of propafenone in the treatment of junctional ectopic tachycardia in children.
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Hewett, K., Gaymes, C., Noh, C. et al. Developmental Cellular Electrophysiologic Effects of Propafenone on the Rabbit Atrioventricular Node. Pediatr Res 32, 658–663 (1992). https://doi.org/10.1203/00006450-199212000-00006
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DOI: https://doi.org/10.1203/00006450-199212000-00006