Effect of disopyramide on initiation of atrial fibrillation and relation to effective refractory period

Meiichi Ito, Seiki Onodera, Junichiro Hashimoto, Hiroo Noshiro, Susumu Shinoda, Michio Nagashima, Hikoyuki Suzuki

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    23 Citations (Scopus)


    Electrophysiologic studies were performed before and after intravenous administration of disopyramide (2 mg/kg) to 40 patients with either documented or suspected atrial fibrillation (AF). In control studies, sustained AF (>1 minute), nonsustained AF (1 to 60 seconds) and no AF were found in 14, 18 and 8 patients, respectively. After disopyramide, the ability to initiate AF was totally lost in 18 patients (group A), while 22 patients (group B) showed sustained AF (11 patients) or nonsustained AF (11 patients). The effective refractory period of the atrium was 232 ± 41 ms in the control study and 266 ± 49 ms after disopyramide. Atrial functional refractory periods before and after disopyramide were 282 ± 43 and 317 ± 48 ms, respectively. The differences and ratios of the refractory periods after and before disopyramide were higher in group A than in group B (p < 0.001). The prolongation of atrial refractoriness after disopyramide was important to suppress the initiation of AF in group A. In some group B patients, on the other hand, the initiation of AF was promoted after disopyramide. Disopyramide may alter the atrial electrophysiologic substrate required for AF initiation.

    Original languageEnglish
    Pages (from-to)561-566
    Number of pages6
    JournalThe American Journal of Cardiology
    Issue number9
    Publication statusPublished - 1989 Mar 1

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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