My primary interest currently is to define the extent to which atrial and ventricular tissues differ in their electrophysiological characteristics and pharmacological response to sodium channel blockers. Our goal is to identify atrial selective sodium channel blockers that may be useful in the management of atrial fibrillation. Among the current strategies for suppressing atrial fibrillation is the development of antiarrhythmic agents that selectively affect atrial electrical parameters. The need for these novel strategies stems from the pro-arrhythmic effect of currently available drugs on the ventricular myocardium. We have recently identified a major atrioventricular distinction in biophysical properties of the sodium channel and a pharmacological agent, ranolazine, which is able to exploit these differences. Ranolazine suppresses sodium channel current–dependent parameters in an atrial selective manner and effectively suppresses atrial fibrillation. Our pilot studies suggest that there are atrial-selective, atrial-predominant, as well as non-selective sodium channel blockers. Investigations into the molecular basis and biophysical mechanisms underlying atrial selectivity of sodium channel blockers are underway.

Burashnikov A, Antzelevitch A. Re-induction of atrial fibrillation immediately after termination of the arrhythmia is mediated by late phase 3 early afterdepolarization-induced triggered activity. Circulation, 2003;107:2355-2360.
PubMed ID: 12695296

Burashnikov A, Mannava S, Antzelevitch C. Transmembrane Action Potential Heterogeneity in the Canine Isolated Arterially-perfused Right Atrium: Effect of IKr and IKur/Ito block. Am.J.Physiol., 2004;286:H2393-H9400.
PubMed ID: 15148061

Burashnikov A, Antzelevitch C. Atrial selective sodium channel block for the treatment of atrial fibrillation. Expert Opinion on Emerging Drugs. 2009;14:233-249.

Burashnikov A, Antzelevitch C. Late phase 3 EAD. A unique mechanism contributing to initiation of atrial fibrillation. PACE, 2006;29:290-295.
PubMed ID: 16606397

Burashnikov A, Di Diego JM, Zygmunt AC, Belardinelli L, Antzelevitch C. Atrial-selective sodium channel block as a strategy for suppression of atrial fibrillation. Differences in sodium channel inactivation between atria and ventricles and the role of ranolazine. Circulation, 2007;116:1449-1457. PubMed ID: 17785620

Burashnikov A, Di Diego JM, Zygmunt AC, Belardinelli L, Antzelevitch C. Atrial-selective sodium channel block as a strategy for suppression of atrial fibrillation.Ann. N.Y. Acad. Sci. 2008;1123:105-112.

Burashnikov A, Antzelevitch C. How do atrial-selective drugs differ from antiarrhythmic drugs currently used in the treatment of atrial fibrillation? Journal of Atrial Fibrillation, 2008;1:98-107.

Burashnikov A, Antzelevitch C. Atrial-selective Sodium Channel Blockers. Do they exist? Journal of Cardiovascular Pharmacology, 2008;52:121-128.

Burashnikov A, Antzelevitch C. Can inhibition of IKur promote atrial fibrillation? Heart Rhythm 2008;5:1304-1309.

Burashnikov A. Are there atrial selective/predominant targets for “upstream” atrial fibrillation therapy? Heart Rhythm, 2008;5:1294-95 (Editorial).

Burashnikov A, Di Diego JM, Sicouri S, Ferreiro M, Carlsson L, Antzelevitch C. Atrial-selective effects of chronic amiodarone in the management of atrial fibrillation. Heart Rhythm 2008;5:1735-42.