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Atypical Antiadrenergic Effect of Refralon as a Mechanism of High Antiarrhythmic Effectiveness

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We studied the effect of Refralon on the electrophysiological properties of the supraventricular myocardium against the background of adrenergic (epinephrine) influence in the zone of the pulmonary veins, the area where 50-90% of atrial arrhythmias is triggered. The experiments were carried out on isolated tissue preparations of Wistar rats. The multichannel microelectrode array technique was used to record action potentials simultaneously in the atrium and in the ostium and distal parts of the pulmonary veins. Epinephrine application (12-50 nM) led to depolarization of the resting potential and the conduction block in the distal part of the pulmonary veins. Refralon (30 μg/kg) restored the resting potential in the distal part of the pulmonary veins. Against the background of epinephrine, Refralon did not significantly change the duration of the action potential at 90% repolarization in comparison with control. At the same time, the comparison drug E-4031 against the background of epinephrine significantly increased the duration of action potential in the atrium and in the ostium of the pulmonary veins, and sotalol increased it only in the ostium. Neither E-4031, nor sotalol restored conduction in their distal part. Refralon has a biphasic effect under conditions of adrenergic stimulation: the fast component is responsible for stabilizing the resting potential in the pulmonary vein and reduces the dispersion of action potential duration in the atrium and pulmonary vein and is also quickly washed away, and the slow component is responsible for the increase of the action potential duration and is slowly washed away.

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References

  1. Ball J, Carrington MJ, McMurray JJ, Stewart S. Atrial fibrillation: profile and burden of an evolving epidemic in the 21st century. Int. J. Cardiol. 2013;167(5):1807-1824. doi: https://doi.org/10.1016/j.ijcard.2012.12.093

    Article  PubMed  Google Scholar 

  2. Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights. Circ. Res. 2020;127(1):4-20. doi: https://doi.org/10.1161/CIRCRESAHA.120.316340

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Métayer P, Clémenty J. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N. Engl. J. Med. 1998;339(10):659-666. doi: https://doi.org/10.1056/NEJM199809033391003

    Article  PubMed  Google Scholar 

  4. Lin WS, Tai CT, Hsieh MH, Tsai CF, Lin YK, Tsao HM, Huang JL, Yu WC, Yang SP, Ding YA, Chang MS, Chen SA. Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy. Circulation. 2003;107(25): 3176-3183. doi: https://doi.org/10.1161/01.CIR.0000074206.52056.2D

    Article  PubMed  Google Scholar 

  5. Della Rocca DG, Tarantino N, Trivedi C, Mohanty S, Anannab A, Salwan AS, Gianni C, Bassiouny M, Al-Ahmad A, Romero J, Briceño DF, Burkhardt JD, Gallinghouse GJ, Horton RP, Di Biase L, Natale A. Non-pulmonary vein triggers in nonparoxysmal atrial fibrillation: Implications of pathophysiology for catheter ablation. J. Cardiovasc. Electrophysiol. 2020;31(8):2154-2167. doi: https://doi.org/10.1111/jce.14638

    Article  PubMed  Google Scholar 

  6. Egorov YV, Rosenshtraukh LV, Glukhov AV. Arrhythmogenic interaction between sympathetic tone and mechanical stretch in rat pulmonary vein myocardium. Front. Physiol. 2020;11:237. doi: https://doi.org/10.3389/fphys.2020.00237

    Article  PubMed  PubMed Central  Google Scholar 

  7. Maykov EB, Yuricheva YA, Mironov NY, Sokolov SF, Golitsyn SP, Rosenshtraukh LV, Chazov EI. Efficacy of a new class III drug niferidil in cardioversion of persistent atrial fibrillation and flutter. J. Cardiovasc. Pharmacol. 2014;64(3):247-255. doi: https://doi.org/10.1097/FJC.0000000000000112

    Article  CAS  PubMed  Google Scholar 

  8. Mironov NYu, Laiovich LYu, Mironova ES, Sharf TV, Aparina OP, Mironova NA, Stukalova OV, Yuricheva YuA, Sokolov SF, Novikov IA, Maykov EB, Pevzner AV, Golitsyn SP. Recent advances in diagnosis and management of atrial fibrillation. Ter. Arkhiv. 2019;91(6):11-18. Russian. https://doi.org/10.26442/00403660.2019.06.000295

  9. Dzaurova KhM, Mironov NYu, Yuricheva YuA, Vlodzyanovsky VV, Gagloeva DA, Laiovich LYu, Malkina TA, Zinchenko LV, Sokolov SF, Golitsyn SP. Efficiency and safety of the modified protocol for cardioversion of atrial fibrillation using domestic antiarrhythmic drug Refralon. Initial clinical results. Kardiol. Vestn. 2021;16(1):49-55. Russian. https://doi.org/10.17116/Cardiobulletin20211601149

  10. Mironov NYu, Yuricheva YuA, Vlodzyanovskiy VV, Sokolov SF, Dzaurova KhM, Golitsyn SP, Shubik YuV, Berman MV, Medvedev MM, Rivin AE, Parkhomchuk DS, Barybin AE, Balandin DA, Batalov RE, Terekhov DS, Evstifeev IV, Kildeev IR, Pyataeva OV, Zenin SA. Safety and effectiveness of pharmacologic conversion of atrial fibrillation and flutter: results of multicenter trial. Part I: study rationale, design and assessment of effectiveness. Rats. Farmakoter. Kardiol. 2021;17(2):193-199. Russian. https://doi.org/10.20996/1819-6446-2021-03-05

  11. Doisne N, Maupoil V, Cosnay P, Findlay I. Catecholaminergic automatic activity in the rat pulmonary vein: electrophysiological differences between cardiac muscle in the left atrium and pulmonary vein. Am. J. Physiol. Heart Circ. Physiol. 2009;297(1):H102-H108. doi: https://doi.org/10.1152/ajpheart.00256.2009

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Y. V. Egorov.

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Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 177, No. 1, pp. 68-73, January, 2024

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Egorov, Y.V. Atypical Antiadrenergic Effect of Refralon as a Mechanism of High Antiarrhythmic Effectiveness. Bull Exp Biol Med (2024). https://doi.org/10.1007/s10517-024-06131-x

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