Unit doses, aerosols, kits, and methods for treating heart conditions by pulmonary administration
Methods of treating atrial arrhythmia include administering an effective amount of at least one antiarrhythmic pharmaceutical agent to a patient in need thereof, such that the at least one antiarrhythmic pharmaceutical agent first enters the heart through the pulmonary vein to the left atrium. Other methods of treating atrial arrhythmia include administering by inhalation an effective amount of at least one antiarrhythmic pharmaceutical agent to a patient in need thereof. An amount of the at least one antiarrhythmic pharmaceutical agent may peak in the coronary sinus of the heart at a time ranging from 10 seconds to 30 minutes from initiation of the administering. Unit doses, aerosols, and kits are also contemplated.
1. A method of treating atrial arrhythmia, comprising:
administering to the pulmonary vein through the pulmonary tract and through the use of an aerosolization device an effective amount of flecainide, to a patient in need thereof,
wherein the aerosolization occurs at room temperature,
wherein the amount of the flecainide is a total amount from 0.1 mg to 100 mg administered over multiple inhalations,
wherein the flecainide level peaks in the coronary sinus of the heart at a time between 30 seconds and 20 minutes from initiation of the pulmonary administration,
wherein the patient's sinus rhythm is restored to normal within 30 minutes of initiating the administration, and
wherein the flecainide results in none to minimal drop in the patient's mean arterial pressure.
2. The method of claim 1 , wherein the concentration of flecainide in the coronary sinus of the heart ranges between 0.1 mg/L and 60 mg/L at 2.5 minutes after initiation of pulmonary administration, and
the concentration of flecainide in the coronary sinus of the heart is less than 0.1 mg/L at 30 minutes after initiation of pulmonary administration, or
wherein 10% to 60% of the nominal dose of administered flecainide reaches the coronary sinus.
3. The method of claim 1 , wherein the concentration of flecainide in the coronary sinus of the heart is between 0.1 mg/L and 20 mg/L at 2.5 minutes after initiation of pulmonary administration, and the concentration of flecainide in the coronary sinus of the heart is less than 0.1 mg/L at 30 minutes after initiation of pulmonary administration, or wherein between 5% and 60% of the nominal dose of administered flecainide reaches the coronary sinus.
4. The method of claim 1 , comprising pulmonary administration of the at least one antiarrhythmic in up to 6 inhalations.
5. The method of claim 1 , wherein the atrial arrhythmia comprises tachycardia, such as supraventricular tachycardia, paroxysmal supraventricular tachycardia, atrial fibrillation, paroxysmal atrial fibrillation, acute episodes in persistent and permanent atrial fibrillation, atrial flutter, paroxysmal atrial flutter or lone atrial fibrillation.
6. The method of claim 1 , comprising administering a liquid dry powder, or nebulized solution comprising flecainide, where the powder, or nebulized droplets have a mass median aerodynamic diameter of less than 10 μm.
7. The method of claim 1 , wherein the flecainide level peaks in the coronary sinus of the heart at a time between 1 minute and 10 minutes.
8. The method of claim 1 , wherein the aerosolization device is a nebulizer configured to administer flecainide in a liquid pharmaceutical formulation.
9. The method of claim 1 , wherein the patient self-administers.