Acute effects of intravenous propafenone on the internal ventricular defibrillation threshold in the anesthetized dog

Abstract

In 10 treated and 2 control dogs, the short-term effects of intravenous propafenone (2 mg/kg/10 minutes, followed by 1 mg/min [ n = 2] or 25 μg/kg/min [ n = 8]) on the internal ventricular defibrillation energy requirements (DER) were investigated. Multiple stored energy levels were randomly tested and the percent successful defibrillation was plotted against the stored energy, and the raw data were fit by logistic regression. The energy at 50% (E 50) and 80% (E 80) defibrillation success increased after propafenone by a mean of 75% (8.4 ± 2.4 to 14.7 ± 5.9 joules, p ≤ 0.05) and 59% (11.1 ± 3.5 to 17.6 ± 6.7 joules, p ≤ 0.05), respectively. Plasma propafenone levels ranged from 778 to 2554 ng/ml (1495 ± 592 ng/ml) at the beginning to 833 to 2193 ng/ml (1297 ± 389 ng/ml) at the end of the defibrillation trials. Two dogs served as controls and received Ringer's solution instead of propafenone and showed the temporal stability of the preparation. In conclusion, intravenous propafenone increases the internal ventricular DER in this canine model. This may have important clinical implications in patients with automatic implantable cardioverter-defibrillators (AICDs) receiving concomitant antiarrhythmic drug therapy and in patients undergoing therapy with intravenous propafenone.