1. The ion channel basis of pharmacological effects of amiodarone on myocardial electrophysiological properties, a comprehensive review.
- Author
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Gelman I, Sharma N, Mckeeman O, Lee P, Campagna N, Tomei N, Baranchuk A, Zhang S, and El-Diasty M
- Subjects
- Humans, Animals, Action Potentials drug effects, Ion Channels metabolism, Ion Channels drug effects, Myocardium metabolism, Electrophysiological Phenomena drug effects, Long QT Syndrome physiopathology, Long QT Syndrome chemically induced, Long QT Syndrome drug therapy, Amiodarone pharmacology, Anti-Arrhythmia Agents pharmacology, Anti-Arrhythmia Agents therapeutic use
- Abstract
Amiodarone is a benzofuran-based class III antiarrhythmic agent frequently used for the treatment of atrial and ventricular arrhythmias. The primary target of class III antiarrhythmic drugs is the cardiac human ether-a-go-go-related gene (hERG) encoded channel, KCNH2, commonly known as HERG, that conducts the rapidly activating delayed rectifier potassium current (I
Kr ). Like other class III antiarrhythmic drugs, amiodarone exerts its physiologic effects mainly through IKr blockade, delaying the repolarization phase of the action potential and extending the effective refractory period. However, while many class III antiarrhythmics, including sotalol and dofetilide, can cause long QT syndrome (LQTS) that can progress to torsade de pointes, amiodarone displays less risk of inducing this fatal arrhythmia. This review article discusses the arrhythmogenesis in LQTS from the aspects of the development of early afterdepolarizations (EADs) associated with Ca2+ current, transmural dispersion of repolarization (TDR), as well as reverse use dependence associated with class III antiarrhythmic drugs to highlight electropharmacological effects of amiodarone on the myocardium., Competing Interests: Declaration of Competing Interest All authors of the manuscript hereby declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)- Published
- 2024
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