Esmolol is a unique cardioselective, intravenous, ultra-short acting, beta1-adrenergic blocking agent. It has been widely applied in treating ventricular and supraventricular arrhythmias, especially in emergency situations. In this study the effects of esmolol on sodium current (I(Na)) were investigated by the whole cell patch-clamp recording technique in isolated adult rat ventricular myocytes. The results indicated that esmolol reversibly inhibited I(Na) in a concentration-dependent manner, with an IC50 of 74.2 +/- 0.60 micromol l(-1) with a Hill coefficient of 1.02 +/- 0.04. This inhibition was voltage- and frequency-dependent. Esmolol decreased the peak of the I-V relationship curve at -35 mV from 16.97 +/- 1.68 pA/pF to 6.96 +/- 0.51 pA/pF. The steady-state inactivation curve of I(Na) was shifted to more negative potentials, the voltage at half-inactivation changing from -78.75 +/- 2.3 mV in control to -85.94 +/- 3.2 mV in the presence of esmolol. The development of resting inactivation from closed states was accelerated by esmolol, the time constant was shortened from 62.75 +/- 3.21 ms to 24.93 +/- 2.43 ms, whereas the activation curve was not altered. I(Na) from inactivation could not be recovered completely in the presence of esmolol. These results suggest that esmolol inhibits I(Na) through sodium channel in rat ventricular myocytes by mechanisms involving preferential interaction with the inactivated state and acceleration of the development of inactivation directly from resting state. Therefore, the effect of inhibitory sodium of esmolol may play a vital role in its antiarrhythmic efficacy.
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