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https://observatorio.fm.usp.br/handle/OPI/36110
Title: | Pulmonary Delivery of Metoprolol Reduces Ventricular Rate During Atrial Fibrillation and Accelerates Conversion to Sinus Rhythm |
Authors: | MARUM, Alexandre A.; SILVA, Bruna Araujo; BORTOLOTTO, Alexandre L.; PEDREIRA, Giovanna C.; SILVA, Fernanda Tessarolo; MEDEIROS, Sofia A.; NEARING, Bruce D.; BELARDINELLI, Luiz; VERRIER, Richard L. |
Citation: | JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, v.75, n.2, p.135-140, 2020 |
Abstract: | Background: Safe, effective pulmonary delivery of cardioactive agents in humans is under development. Objectives: We examined whether intratracheal delivery of metoprolol can reduce ventricular rate during atrial fibrillation (AF) and accelerate conversion to sinus rhythm. Methods: In 7 closed-chest, anesthetized Yorkshire pigs, AF was induced by intrapericardial infusion of acetylcholine (1 mL of 102.5-mM solution) followed by atrial burst pacing and was allowed to continue for 2 minutes before intratracheal instillation of sterile water or metoprolol (0.2-mg/kg bolus) using a catheter positioned at the bifurcation of the main bronchi. High-resolution electrograms were obtained from catheters fluoroscopically positioned in the right atrium and left ventricle. Results: Rapid intratracheal instillation of metoprolol caused a 32-beat/min reduction in ventricular rate during AF (from 272 +/- 13.7 to 240 +/- 12.6 beats/min, P = 0.008) and a 2.3-minute reduction in AF duration (from 10.3 +/- 2.0 to 8.0 +/- 1.4 minutes, P = 0.018) compared with sterile water control. Conversion of AF to sinus rhythm was associated with rapid restoration (5-6 minutes) of heart rate and arterial blood pressure toward control values. Intratracheal metoprolol reduced AF dominant frequency by 31% (from 8.7 +/- 0.9 to 6.0 +/- 1.1 Hz, P = 0.04) compared with control and resulted in a trend toward a 5% increase in PR interval (from 174 +/- 11.2 to 182 +/- 11.4 ms, P = 0.07). Conclusions: Intratracheal delivery of metoprolol effectively reduces ventricular rate during AF and accelerates conversion to normal sinus rhythm in a pig model of acetylcholine-induced AF. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/Outros Artigos e Materiais de Revistas Científicas - LIM/04 Artigos e Materiais de Revistas Científicas - LIM/11 |
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