Relative Role of Alkalosis and Sodium Ions in Reversal of Class I Antiarrhythmic Drug–Induced Sodium Channel Blockade by Sodium Bicarbonate

Abstract

Increases in sodium bicarbonate concentration reverse the effects of class I antiarrhythmic drugs to a varying extent, with drug-specific contributions of the sodium and bicarbonate moiety. The molecular basis for this drug specificity remains to be elucidated, but it has important potential implications for the use of hypertonic sodium salts to treat cardiotoxicity caused by sodium channel-blocking drugs.