Effect of quinidine and bretylium on defibrillation energy requirements

https://doi.org/10.1016/0002-8703(86)90672-1Get rights and content

Abstract

We examined the effect of bretylium and quinidine on the energy requirements for internal defibrillation in 14 pentobarbital-anesthetized dogs. Bretylium, 6 or 10 mg/kg (n = 6), did not affect the relation between energy and the likelihood of successful defibrillation. The mean energy required to achieve 50% success (E50) or 90% success (E90) in defibrillation was not significantly altered; E50 was 5.3 ± 1.9 J (x ± s.d) before and 6.1 ± 3.5 J after bretylium (n.s.), and E90 was 7.2 ± 2.1 J before and 8.6 ± 3.3 J after drug (n.s.). Quinidine was administered in a series of two loading and maintenance infusions to achieve mean plasma concentrations of 2.4 ± 0.63 and 2.95 ± 0.88 μg/ml, respectively (n = 8). No significant effect on defibrillation energy requirement was observed; mean E50 before and after treatment was 6.3 ± 3.3 J and 6.2 ± 2.9 J, respectively, and mean E90 was 8.3 ± 4.4 J and 8.3 ± 4.1 J, respectively. Similarly, saline administration to control dogs (n = 12) resulted in no change in E50 or E90. At concentrations or doses similar to those in patients with serious arrhythmias, neither quinidine nor bretylium appears to have consistent effects on the energy requirements for internal defibrillation in our dog model.

References (18)

There are more references available in the full text version of this article.

Cited by (47)

  • Testing and programming of implantable defibrillator functions at implantation

    2007, Clinical Cardiac Pacing, Defibrillation, and Resynchronization Therapy
  • Testing and programming of implantable defibrillator functions at implantation

    2006, Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy
  • Effects of antiarrhythmic medication on implantable cardioverter- defibrillator function

    2000, American Journal of Cardiology
    Citation Excerpt :

    As opposed to the class I agents, class III agents (other than amiodarone) appear either to have no effect or to lower the DFT. In canine preparations, bretylium had no effect,12,16 while N-acetyl procainamide (NAPA), a metabolite of procainamide with pure class III effects, significantly reduced the DFT.13 Sotalol was associated with a reduction in the E50 (energy that resulted in cardioversion 50% of the time) by 16%.22

  • Drugs in modern resuscitation

    1997, British Journal of Anaesthesia
View all citing articles on Scopus

This research was supported in part by a gift from Intec Systems, Inc., Pittsburgh, Pa.

1

Dr. Dorian was supported by a fellowship from the Medical Research Council of Canada.

2

Mr. Fain is an American Heart Association Medical Student Research Fellow.

Current address: Service de Cardiologie Hospital A. Beclere, 157 rue de la Porte de Trivaux, 92141, Clamart, France.

3

Dr. Davy was supported by a grant from the Fondation pour La Recherche Medicale.

∗∗

Current address: Cardiovascular Medicine, 770 Welch Rd., Suite 100, Palo Alto CA 94304.

View full text