Epicardial amiodarone therapy for atrial fibrillation : delivery methods, drug distribution and antiarrhythmic effects

Atrial fibrillation is a very common cardiac rhythm disorder that increases the risk of a stroke and early death. This PhD research investigated if the treatment of atrial fibrillation can be improved by delivering the drug amiodaron directly to the heart. The higher medicine concentrations in the heart and the lower concentrations in the rest of the body thus realize a greater effect while the risk of side-effects decreases. This dissertation describes various methods, such as injecting medicine solutions in the pericardium and applying (biodegradable) hydrogels and patches that can deliver medicines directly to the heart. The research shows that particularly this last method is effective in selectively suppressing atrial rhythm disorders while the medicine levels in the other parts of the heart and the body are limited to a minimum.