Effects of 17β-estradiol on tachycardia-induced changes of atrial refractoriness and cisapride-induced ventricular arrhythmia

Yi Jen Chen, Shih Huang Lee, Ming Hsiung Hsieh, Chien Ju Hsiao, Wen Chung Yu, Chuen Wang Chiou, Shih Ann Chen

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Introduction: Gender difference is known to be associated with the occurrence of arrhythmia. However, the effects of female sex hormone on atrial electrophysiology, and on the occurrence of torsades de pointes (TdP) induced by cisapride have been unclear. Methods and Results: Two experiments were included in this study. In experiment 1, effective refractory periods (ERPs) from five epicardial atrial sites were measured before and after rapid atrial pacing at 800 beats/min for 30 minutes in dogs with pretreatment of verapamil (n = 10), 17β-estradiol (n = 10), or without pretreatment (n - 10, control group). In experiment 2, limb-lead ECG and monophasic action potentials in the left and right ventricles were recorded before and after each dose of cisapride (2 to 6 mg/kg) during different ventricular rates in dogs with (n = 9) and without (n = 14) concomitant administration of 17β- estradiol (0.3 μg/kg). After 17β-estradiol administration, there were greater atrial ERPs in the study dogs than in the control group. The atrial ERPs were shortened significantly after rapid atrial pacing, but the degree was greater in the control group than in the dogs pretreated with verapamil or 17β-estradiol. Moreover, the recovery of atrial ERPs was faster in dogs pretreated with verapamil or 17β-estradiol than in the control group. In experiment 2, cisapride prolonged the QT interval and biventricular APD90 and induced early afterdepolarizations (EADs) in a dose-dependent manner. However, dogs receiving cisapride combined with 17β-estradiol had a greater increase of ventricular repolarization and a higher incidence of EADs than those receiving cisapride only. Moreover, dogs receiving cisapride combined with 17β-estradiol (3/9, 33%) had a greater incidence of TdP than those receiving cisapride only (0/14, 0%, P <0.05). Conclusions: 17β-estradiol has a significant effect on atrial electrophysiology, which may be related to the prevention of atrial fibrillation. However, the high incidence of TdP in dogs receiving cisapride combined with 17β-estradiol suggests that the female sex hormone is an important risk factor of cisapride-induced proarrhythmia.

Original languageEnglish
Pages (from-to)587-598
Number of pages12
JournalJournal of Cardiovascular Electrophysiology
Volume10
Issue number4
Publication statusPublished - 1999
Externally publishedYes

Fingerprint

Cisapride
Tachycardia
Cardiac Arrhythmias
Estradiol
Dogs
Torsades de Pointes
Verapamil
Control Groups
Electrophysiology
Gonadal Steroid Hormones
Heart Ventricles
Incidence
Atrial Fibrillation
Action Potentials
Electrocardiography
Extremities

Keywords

  • Atrial fibrillation
  • Cisapride
  • Estrogen
  • Long QT syndrome
  • Torsades de pointes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Effects of 17β-estradiol on tachycardia-induced changes of atrial refractoriness and cisapride-induced ventricular arrhythmia. / Chen, Yi Jen; Lee, Shih Huang; Hsieh, Ming Hsiung; Hsiao, Chien Ju; Yu, Wen Chung; Chiou, Chuen Wang; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 10, No. 4, 1999, p. 587-598.

Research output: Contribution to journalArticle

Chen, Yi Jen ; Lee, Shih Huang ; Hsieh, Ming Hsiung ; Hsiao, Chien Ju ; Yu, Wen Chung ; Chiou, Chuen Wang ; Chen, Shih Ann. / Effects of 17β-estradiol on tachycardia-induced changes of atrial refractoriness and cisapride-induced ventricular arrhythmia. In: Journal of Cardiovascular Electrophysiology. 1999 ; Vol. 10, No. 4. pp. 587-598.
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abstract = "Introduction: Gender difference is known to be associated with the occurrence of arrhythmia. However, the effects of female sex hormone on atrial electrophysiology, and on the occurrence of torsades de pointes (TdP) induced by cisapride have been unclear. Methods and Results: Two experiments were included in this study. In experiment 1, effective refractory periods (ERPs) from five epicardial atrial sites were measured before and after rapid atrial pacing at 800 beats/min for 30 minutes in dogs with pretreatment of verapamil (n = 10), 17β-estradiol (n = 10), or without pretreatment (n - 10, control group). In experiment 2, limb-lead ECG and monophasic action potentials in the left and right ventricles were recorded before and after each dose of cisapride (2 to 6 mg/kg) during different ventricular rates in dogs with (n = 9) and without (n = 14) concomitant administration of 17β- estradiol (0.3 μg/kg). After 17β-estradiol administration, there were greater atrial ERPs in the study dogs than in the control group. The atrial ERPs were shortened significantly after rapid atrial pacing, but the degree was greater in the control group than in the dogs pretreated with verapamil or 17β-estradiol. Moreover, the recovery of atrial ERPs was faster in dogs pretreated with verapamil or 17β-estradiol than in the control group. In experiment 2, cisapride prolonged the QT interval and biventricular APD90 and induced early afterdepolarizations (EADs) in a dose-dependent manner. However, dogs receiving cisapride combined with 17β-estradiol had a greater increase of ventricular repolarization and a higher incidence of EADs than those receiving cisapride only. Moreover, dogs receiving cisapride combined with 17β-estradiol (3/9, 33{\%}) had a greater incidence of TdP than those receiving cisapride only (0/14, 0{\%}, P <0.05). Conclusions: 17β-estradiol has a significant effect on atrial electrophysiology, which may be related to the prevention of atrial fibrillation. However, the high incidence of TdP in dogs receiving cisapride combined with 17β-estradiol suggests that the female sex hormone is an important risk factor of cisapride-induced proarrhythmia.",
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AU - Lee, Shih Huang

AU - Hsieh, Ming Hsiung

AU - Hsiao, Chien Ju

AU - Yu, Wen Chung

AU - Chiou, Chuen Wang

AU - Chen, Shih Ann

PY - 1999

Y1 - 1999

N2 - Introduction: Gender difference is known to be associated with the occurrence of arrhythmia. However, the effects of female sex hormone on atrial electrophysiology, and on the occurrence of torsades de pointes (TdP) induced by cisapride have been unclear. Methods and Results: Two experiments were included in this study. In experiment 1, effective refractory periods (ERPs) from five epicardial atrial sites were measured before and after rapid atrial pacing at 800 beats/min for 30 minutes in dogs with pretreatment of verapamil (n = 10), 17β-estradiol (n = 10), or without pretreatment (n - 10, control group). In experiment 2, limb-lead ECG and monophasic action potentials in the left and right ventricles were recorded before and after each dose of cisapride (2 to 6 mg/kg) during different ventricular rates in dogs with (n = 9) and without (n = 14) concomitant administration of 17β- estradiol (0.3 μg/kg). After 17β-estradiol administration, there were greater atrial ERPs in the study dogs than in the control group. The atrial ERPs were shortened significantly after rapid atrial pacing, but the degree was greater in the control group than in the dogs pretreated with verapamil or 17β-estradiol. Moreover, the recovery of atrial ERPs was faster in dogs pretreated with verapamil or 17β-estradiol than in the control group. In experiment 2, cisapride prolonged the QT interval and biventricular APD90 and induced early afterdepolarizations (EADs) in a dose-dependent manner. However, dogs receiving cisapride combined with 17β-estradiol had a greater increase of ventricular repolarization and a higher incidence of EADs than those receiving cisapride only. Moreover, dogs receiving cisapride combined with 17β-estradiol (3/9, 33%) had a greater incidence of TdP than those receiving cisapride only (0/14, 0%, P <0.05). Conclusions: 17β-estradiol has a significant effect on atrial electrophysiology, which may be related to the prevention of atrial fibrillation. However, the high incidence of TdP in dogs receiving cisapride combined with 17β-estradiol suggests that the female sex hormone is an important risk factor of cisapride-induced proarrhythmia.

AB - Introduction: Gender difference is known to be associated with the occurrence of arrhythmia. However, the effects of female sex hormone on atrial electrophysiology, and on the occurrence of torsades de pointes (TdP) induced by cisapride have been unclear. Methods and Results: Two experiments were included in this study. In experiment 1, effective refractory periods (ERPs) from five epicardial atrial sites were measured before and after rapid atrial pacing at 800 beats/min for 30 minutes in dogs with pretreatment of verapamil (n = 10), 17β-estradiol (n = 10), or without pretreatment (n - 10, control group). In experiment 2, limb-lead ECG and monophasic action potentials in the left and right ventricles were recorded before and after each dose of cisapride (2 to 6 mg/kg) during different ventricular rates in dogs with (n = 9) and without (n = 14) concomitant administration of 17β- estradiol (0.3 μg/kg). After 17β-estradiol administration, there were greater atrial ERPs in the study dogs than in the control group. The atrial ERPs were shortened significantly after rapid atrial pacing, but the degree was greater in the control group than in the dogs pretreated with verapamil or 17β-estradiol. Moreover, the recovery of atrial ERPs was faster in dogs pretreated with verapamil or 17β-estradiol than in the control group. In experiment 2, cisapride prolonged the QT interval and biventricular APD90 and induced early afterdepolarizations (EADs) in a dose-dependent manner. However, dogs receiving cisapride combined with 17β-estradiol had a greater increase of ventricular repolarization and a higher incidence of EADs than those receiving cisapride only. Moreover, dogs receiving cisapride combined with 17β-estradiol (3/9, 33%) had a greater incidence of TdP than those receiving cisapride only (0/14, 0%, P <0.05). Conclusions: 17β-estradiol has a significant effect on atrial electrophysiology, which may be related to the prevention of atrial fibrillation. However, the high incidence of TdP in dogs receiving cisapride combined with 17β-estradiol suggests that the female sex hormone is an important risk factor of cisapride-induced proarrhythmia.

KW - Atrial fibrillation

KW - Cisapride

KW - Estrogen

KW - Long QT syndrome

KW - Torsades de pointes

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