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Kazuharu Furutani, Kunichika Tsumoto, I-Shan Chen, Kenichiro Handa, Yuko Yamakawa, Jon T Sack, Yoshihisa Kurachi
Drug-induced block of the cardiac rapid delayed rectifying potassium current ( I Kr ), carried by the human ether-a-go-go-related gene (hERG) channel, is the most common cause of acquired long QT syndrome. Indeed, some, but not all, drugs that block hERG channels cause fatal cardiac arrhythmias. However, there is no clear method to distinguish between drugs that cause deadly arrhythmias and those that are clinically safe. Here we propose a mechanism that could explain why certain clinically used hERG blockers are less proarrhythmic than others...
January 23, 2019: Journal of General Physiology
Tetsuma Kawaji, Satoshi Shizuta, Shintaro Yamagami, Takanori Aizawa, Akihiro Komasa, Takashi Yoshizawa, Masashi Kato, Takafumi Yokomatsu, Shinji Miki, Koh Ono, Takeshi Kimura
Background: Radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF) is still challenging even in RFCA-era for AF. The aim of this study was to assess the clinical utility of nifekalant, a pure potassium channel blocker,during RFCA for persistent AF. Methods and results: We retrospectively enrolled 157 consecutive persistentAF patientsundergoing first RFCA procedure withcomplex fractionated atrial electrogram (CFAE)ablation after pulmonary veins isolation and compared outcomes between patientswith (NFK group: N=79) and without (No-NFK group: N=78)additional CFAE ablation using intravenous nifekalant (0...
June 2018: Journal of Atrial Fibrillation
Tomomichi Ishizaka, Yu Yoshimatsu, Yu Maeda, Katsuyoshi Chiba, Kazuhiko Mori
The present study was conducted to clarify multiple cardiohemodynamic and electrophysiological properties including inotropic/lusitropic effects of nifekalant, a class III antiarrhythmic drug, in an isoflurane-anesthetized monkey. Nifekalant was administered intravenously at the therapeutic dose of 0.3 mg/kg over 10 minutes to male cynomolgus monkeys (n=4), followed by higher dose of 1 (n=3) or 3 mg/kg (n=1) that was limited due to arrythmogenicity. Left ventricular (LV) pressure-volume (PV) analysis revealed that the 0...
October 17, 2018: Experimental Animals
George Karlis, Sevasti Afantenou
Since the publication of 2000 guidelines for resuscitation, amiodarone is considered the antiarrhythmic drug of choice for refractory ventricular fibrillation/pulseless ventricular tachycardia. However, to date there is no proven benefit in terms of neurologically intact survival to hospital discharge. A comprehensive search of the recent literature on amiodarone, nifekalant and lidocaine in cardiac arrest was performed. Amiodarone and nifekalant are superior to lidocaine with regards to the return of spontaneous circulation and survival to hospital admission...
August 2018: Acta Cardiologica
Amelia Chowdhury, Brian Fernandes, Thomas M Melhuish, Leigh D White
INTRODUCTION: It is widely accepted that antiarrhythmics play a role in cardiopulmonary resuscitation (CPR) universally, but the absolute benefit of antiarrhythmic use and the drug of choice in advanced life support remains controversial. AIM: To perform a thorough, in-depth review and analysis of current literature to assess the efficacy of antiarrhythmics in advanced life support. MATERIAL AND METHODS: Two authors systematically searched through multiple bibliographic databases including CINAHL, SCOPUS, PubMed, Web of Science, Medline(Ovid) and the Cochrane Clinical Trials Registry...
March 2018: Heart, Lung & Circulation
Shiho Sato, Yoshito Zamami, Toru Imai, Satoshi Tanaka, Toshihiro Koyama, Takahiro Niimura, Masayuki Chuma, Tadashi Koga, Kenshi Takechi, Yasuko Kurata, Yutaka Kondo, Yuki Izawa-Ishizawa, Toshiaki Sendo, Hironori Nakura, Keisuke Ishizawa
Amiodarone (AMD) and nifekalant (NIF) are used in the treatment of ventricular fibrillation or tachycardia; however, only few studies have been conducted on their efficacies. Therefore, a meta-analysis was conducted. Relevant sources were identified from PubMed, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi. The outcomes were short-term and long-term survival in patients with shock-resistant ventricular fibrillation /pulseless ventricular tachycardia. Thirty-three studies were analysed...
October 4, 2017: Scientific Reports
Hisaaki Aoki, Tsugutoshi Suzuki, Hikoro Matsui, Satoshi Yasukochi, Hirofumi Saiki, Hideaki Senzaki, Yoshihide Nakamura
No abstract text is available yet for this article.
June 2017: HeartRhythm Case Reports
Sou Otuki, Kanae Hasegawa, Hiroshi Watanabe, Goro Katsuumi, Nobue Yagihara, Kenichi Iijima, Akinori Sato, Daisuke Izumi, Hiroshi Furushima, Masaomi Chinushi, Yoshifusa Aizawa, Tohru Minamino
BACKGROUND: Patients with repetitive ventricular tachyarrhythmias - so-called electrical storm - frequently require antiarrhythmic drugs. Amiodarone is widely used for the treatment of electrical storm but is ineffective in some patients. Therefore, we investigated the efficacy of stepwise administration of nifekalant, a pure potassium channel blocker, and mexiletine for electrical storm. METHODS: This study included 44 patients with repetitive ventricular tachyarrhythmias who received stepwise therapy with nifekalant and mexiletine for electrical storm...
May 2017: Journal of Electrocardiology
Sayaka Sasaoka, Toshinobu Matsui, Yuuki Hane, Junko Abe, Natsumi Ueda, Yumi Motooka, Haruna Hatahira, Akiho Fukuda, Misa Naganuma, Shiori Hasegawa, Yasutomi Kinosada, Mitsuhiro Nakamura
Long QT syndrome (LQTS) is a disorder of the heart's electrical activity that infrequently causes severe ventricular arrhythmias such as a type of ventricular tachycardia called torsade de pointes (TdP) and ventricular fibrillation, which can be fatal. There have been no previous reports on the time-to-onset for LQTS based on data from spontaneous reporting systems. The aim of this study was to assess the time-to-onset of LQTS according to drug treatment. We analyzed the association between 113 drugs in 37 therapeutic categories and LQTS including TdP using data obtained from the Japanese Adverse Drug Event Report database...
2016: PloS One
Takashi Tagami, Hiroki Matsui, Saori Ishinokami, Masao Oyanagi, Akiko Kitahashi, Reo Fukuda, Kyoko Unemoto, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: We evaluated the association between nifekalant or amiodarone on hospital admission and in-hospital mortality for cardiac arrest patients with persistent ventricular fibrillation on hospital arrival. METHODS: This was a retrospective cohort study using the Japanese Diagnosis Procedure Combination inpatient database. We identified 2961 patients who suffered cardiogenic out-of-hospital cardiac arrest and who had ventricular fibrillation on hospital arrival between July 2007 and March 2013...
December 2016: Resuscitation
Ageliki Laina, George Karlis, Aris Liakos, Georgios Georgiopoulos, Dimitrios Oikonomou, Evangelia Kouskouni, Athanasios Chalkias, Theodoros Xanthos
INTRODUCTION: The 2015 Guidelines for Resuscitation recommend amiodarone as the antiarrhythmic drug of choice in the treatment of resistant ventricular fibrillation or pulseless ventricular tachycardia. We reviewed the effects of amiodarone on survival and neurological outcome after cardiac arrest. METHODS: We systematically searched MEDLINE and Cochrane Library from 1940 to March 2016 without language restrictions. Randomized control trials (RCTs) and observational studies were selected...
October 15, 2016: International Journal of Cardiology
Makoto Suzuki, Wataru Nagahori, Akira Mizukami, Akihiko Matsumura, Yuji Hashimoto
BACKGROUND: Ventricular tachyarrhythmias (VTs) are life-threatening events that result in hemodynamic compromise. Recurrence is common and may worsen a patient׳s clinical course despite appropriate treatment. This study aimed to examine the effectiveness of antiarrhythmic drugs for suppression of VTs. METHODS: In this cohort study, eligible patients were those who were admitted to one of the nine cardiovascular care centers and treated with continuous infusion of an antiarrhythmic drug for at least 1 h to prevent recurrence of VTs after return of spontaneous circulation...
June 2016: Journal of Arrhythmia
Nobuya Harayama, Shun-Ichi Nihei, Keiji Nagata, Keiji Aibara, Masayuki Kamochi, Takeyoshi Sata
Early direct current (DC) shock is the most important therapy for ventricular fibrillation. Following the increased availability of automated external defibrillators (AED), the survival rate of cardiopulmonary arrest patients with ventricular fibrillation has improved. Although patients with shock-resistant ventricular fibrillation require additional antiarrhythmic drug therapy, the optimal protocol has not been established. Nifekalant is a pure potassium channel blocker with a pyrimidinedione structure. Nifekalant was approved in Japan for the treatment of life-threatening ventricular tachyarrhythmias in 1999, and is widely used as a class III antiarrhythmic intravenous drug...
March 1, 2016: Journal of UOEH
Fuminori Namino, Yasuhisa Iriki, Ryuichi Maenosono, Hitoshi Ichiki, Hideki Okui, Akino Yoshimura, Naoya Oketani, Masakaze Matsushita, Mitsuru Ohishi, Teruto Hashiguchi
BACKGROUND: Complex fractionated atrial electrogram (CFAE)-targeted catheter ablation (CFAE ablation) requires a high rate of atrial fibrillation (AF) termination to provide good outcomes. We determined the optimal settings of CFAE software. METHODS: In our 430 consecutive patients, AF was terminated in 97 (234/242) and 79% (149/188) of patients with paroxysmal and persistent AF, respectively, by CFAE ablation combined with (31%) or without (69%) pulmonary vein isolation, occasionally with nifekalant infusion...
February 2015: Journal of Arrhythmia
Mari Amino, Sadaki Inokuchi, Ken Nagao, Yoshihide Nakagawa, Koichiro Yoshioka, Yuji Ikari, Hiraku Funakoshi, Katsura Hayakawa, Masakazu Matsuzaki, Atsushi Sakurai, Yoshio Tahara, Naohiro Yonemoto, Arino Yaguchi, Naoto Morimura
BACKGROUND: Amiodarone (AMD), nifekalant (NIF), and lidocaine (LID) hydrochlorides are widely used for ventricular tachycardia/fibrillation (VT/VF). This study retrospectively investigated the NIF potency and the differential effects of 2 initial AMD doses (≤150 mg or 300 mg) in the Japanese SOS-KANTO 2012 study population. METHODS AND RESULTS: From 16,164 out-of-hospital cardiac arrest cases, 500 adult patients using a single antiarrhythmic drug for shock-resistant VT/VF were enrolled and categorized into 4 groups (73 LID, 47 NIF, 173 AMD-≤150, and 207 AMD-300)...
December 2015: Journal of Cardiovascular Pharmacology
George Karlis, Nicoletta Iacovidou, Pavlos Lelovas, Panagiota Niforopoulou, Apostolos Papalois, Ioanna Siafaka, Spyros Mentzelopoulos, Theodoros Xanthos
PURPOSE: The purpose of the experiment was to compare the effects of nifekalant and amiodarone on the return of spontaneous circulation (ROSC), survival, as well as on the hemodynamic parameters in a swine model of prolonged ventricular fibrillation (VF). METHODS: After 8 min of untreated VF, bolus doses of epinephrine (adrenaline) and either nifekalant, or amiodarone, or saline (n = 10 per group), were administered after randomization. Cardiopulmonary resuscitation (CPR) was commenced immediately after drug administration and defibrillation was attempted 2 min later...
2015: Cardiovascular Drugs and Therapy
Katsuyuki Kazusa, Yuji Nakamura, Yudai Watanabe, Kentaro Ando, Atsushi Sugiyama
Since information regarding the effects of pH on the extent of nifekalant-induced repolarization delay and torsades de pointes remains limited, we assessed it with a Langendorff heart model of guinea pigs. First, we investigated the effects of pH change from 7.4 to 6.4 on the bipolar electrogram simulating surface lead II ECG, monophasic action potential (MAP), effective refractory period (ERP), and terminal repolarization period (TRP) and found that acidic condition transiently enhanced the ventricular repolarization...
2014: Journal of Pharmacological Sciences
Nobuya Harayama, Shun-ichi Nihei, Keiji Nagata, Yasuki Isa, Kei Goto, Keiji Aibara, Masayuki Kamochi, Takeyoshi Sata
PURPOSE: Nifekalant is a pure potassium channel blocker that has been used to treat ventricular tachyarrhythmias since 1999 in Japan. Intravenous amiodarone was approved later than nifekalant in Japan, and it is still unclear which of the two agents is superior. The aim of this study was to compare the efficacy of nifekalant and amiodarone for resuscitation of out-of-hospital cardiopulmonary arrest caused by shock-resistant ventricular fibrillation. METHODS: From December 2005 to January 2011, ambulance services transported 283 out-of-hospital cardiopulmonary arrest patients to our hospital...
August 2014: Journal of Anesthesia
Kazumasa Sonoda, Ichiro Watanabe, Kimie Ohkubo, Yasuo Okumura, Masayoshi Kofune, Naoko Sasaki, Rikitake Kogawa, Hiroaki Mano, Toshiko Nakai, Atsushi Hirayama
Persistent atrial fibrillation (AF) is characterized by electrical remodeling, ie, marked decreases in the atrial effective refractory period (ERP), ERP rate adaptation, and atrial conduction velocity. Little information is available on the effects of class III antiarrhythmic drugs on the remodeled atrium. We studied the effects of the class III antiarrhythmic drugs nifekalant, ibutilide, and amiodarone on rate-dependent changes in atrial action potential duration in patients with persistent AF. Right atrial (RA) monophasic action potential duration (MAPD) and intra-atrial conduction time (IACT) were measured at pacing cycle lengths (CLs) of 800, 700, 600, 500, 400, 350, 300, and 250 ms before and after administration of nifekalant (0...
2013: International Heart Journal
Mengmeng Zhang, Guobing Shi, Yin Sui, Ye An, Ming Yan, Yunbiao Tang
In the present study, a simple, rapid, and accurate liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of the concentration of Nifekalant in human plasma was developed and validated. The analyte and the internal standard were extracted from human plasma using dichloromethane and analyzed using an ultra-fast liquid chromatographer (UFLC) coupled to an electrospray ionization (ESI) tandem mass spectrometer in the positive mode. The chromatographic analysis was performed isocratically on an Inertsil ODS-SP column (150mm×4...
November 1, 2013: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
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