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Antiarrhythmic agent - Wikipedia, the free encyclopedia Antiarrhythmic agents are a group of pharmaceuticals that are used to suppress fast rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. Antiarrhythmic agents may be considered the first-line therapy in the prevention of sudden death in certain forms of structural heart disease, and failure of these agents to suppress arrhythmias may lead to implantation of an implantable cardioverter-defibrillator (ICD). In this case, the ICD is used to prevent sudden death due to ventricular fibrillation, while the antiarrhythmic agent(s) are used to suppress ventricular tachyarrhythmias so that the ICD doesn't shock the patient frequently. en.wikipedia.org /wiki/Antiarrhythmic_agent   (1294 words)

Internal Cardioverter Defibrillator (ICD) and Antiarrhythmic Drug Interaction Antiarrhythmic drug therapy selected by electrophysiological study or ambulatory monitoring or prescribed empirically. The role of antiarrhythmic drugs combined with an ICD has not been thoroughly evaluated, though several clinical trials have been conducted. Antiarrhythmic therapy, with the possible exception of sotalol, should be prescribed selectively in patients with ICDs, given their potential for cardiac and noncardiac toxicity. www.americanheart.org /presenter.jhtml?identifier=3001594   (454 words)

Issues in Bioequivalence and Generic Substitution for Antiarrhythmic Drugs Problems are particularly apt to arise when a pharmacist substitutes a generic drug for a brand-name drug, because the antiarrhythmic properties or potential toxic effects of the two drugs may not be clinically equivalent. Though they both may be considered “bioequivalent” to the innovator drug, one generic may have achieved values that lie between 80% and 100% of the innovator’s and another values that lie between 100% and 125%. Unlike many other classes of drugs (the members of which can be interchanged with relative impunity), the choice of antiarrhythmic drugs must be governed by due consideration of the unique characteristics of each drug, not by those of its class. www.americanheart.org /presenter.jhtml?identifier=3015266   (2623 words)

Amiodarone: From Last to First-Line Antiarrhythmic Therapy AUC is proportional to the extent of drug absorption. Antiarrhythmic drugs represent a class of agents that should be considered critical-dose, narrow therapeutic ratio drugs. Antiarrhythmic drugs are used to prevent recurrences of supraventricular or ventricular arrhythmias or to convert these arrhythmias to normal sinus rhythm. www.continuingeducation.com /pharmacy/amiodarone/issues.html   (2377 words)

Antiarrhythmic drugs Antiarrhythmic drugs are medicines that correct irregular heartbeats and slow down hearts that beat too fast. Antiarrhythmic drugs are available only with a physician's prescription and are sold in capsule (regular and extended release), tablet (regular and extended-release), and injectable forms. Antiarrhythmic drugs may cause low blood sugar, which can be a particular problem for people with congestive heart disease. www.healthatoz.com /healthatoz/Atoz/ency/antiarrhythmic_drugs.jsp   (1655 words)

British Journal of Pharmacology - Tedisamil and lidocaine enhance each other's antiarrhythmic activity against ... Combinations of the action potential-widening drug tedisamil (Class III antiarrhythmic activity), and the inactivated state sodium channel blocker lidocaine (Class Ib antiarrhythmic activity) were assessed for antiarrhythmic actions in a rat model of ischaemia-induced arrhythmias and for electrophysiological actions in normal rat myocardial tissue. In contrast to the strategy of developing drugs that are selective for a single electrophysiological mechanism, the results of the present study suggest that effective antiarrhythmic drugs might be developed by optimising the combination of two complimentary electrophysiological mechanisms (i.e., action potential-prolonging activity and inactivated state sodium channel blockade). Antiarrhythmic dose−response curves for tedisamil and combinations of tedisamil and lidocaine as compared to vehicle control (a), or relative to the antiarrhythmic protection produced by the dose of lidocaine that was coadministered (b). www.nature.com /bjp/journal/v139/n8/full/0705373a.html   (6452 words)

Amiodarone: From Last to First-Line Antiarrhythmic Therapy Antiarrhythmic drugs with AV nodal-blocking properties suppress the occurrence of the arrhythmia, but RFA is curative. CAST-I, which evaluated the class IC antiarrhythmic drugs encainide and flecainide, was terminated after a mean of 10 months of treatment because of increased mortality in the patients randomized to receive flecainide or encainide compared with those who received placebo. Patients receiving antiarrhythmic medications should be counseled on the warning signs of arrhythmia (eg, syncope, light-headedness, dizziness, or palpitations); adverse effects specific to the antiarrhythmic drug selected; importance of adherence to the prescribed drug regimen; importance of making follow-up appointments with their physicians; and potential consequences of changing antiarrhythmic drug brands. www.continuingeducation.com /pharmacy/amiodarone/trends.html   (1864 words)

Guidance for Industry: E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Drugs are expected to receive a clinical electrocardiographic evaluation, beginning early in clinical development, typically including a single trial dedicated to evaluating their effect on cardiac repolarization ("thorough QT/QTc study"). Drugs that prolong the mean QT/QTc interval by >20 ms have a substantially increased likelihood of being proarrhythmic, and might have clinical arrhythmic events captured during drug development. Demonstrated benefits of the drug in resistant populations or in patients who are intolerant of, or have a labeled contraindication to, approved drugs for the same disease represent additional relevant clinical considerations that might justify approval of the drug, if the indication were limited to use in such patients. www.fda.gov /cder/guidance/6922fnl.htm   (6186 words)

Comprehensive Cardiovascular Care Group:Drug Therapy Specific drug therapy is chosen based on the underlying arrhythmia, dosing schedule, side effects, and the presence of other cardiac, pulmonary, liver, or renal disease. Given the potential for most of the antiarrhythmic agents to provoke serious rhythm disturbances in patients with underlying heart disease, amiodarone’s track record of relative safety in patients with coronary artery disease and congestive heart failure is a distinct advantage in this patient population. Sotalol is an antiarrhythmic drug belonging to the class of drugs termed Beta-receptor blocking drugs or beta-blockers. www.hrtcare.com /drugweg.asp   (1253 words)

NEJM -- A comparison of electrophysiologically guided antiarrhythmic drug therapy with beta-blocker therapy in patients ... Antiarrhythmic drug therapy guided by invasive electrophysiologic testing is now widely used in patients with symptomatic, sustained ventricular tachyarrhythmias. Only 6 of the 29 patients (21 percent) with inducible arrhythmia that became noninducible during drug therapy had recurrent arrhythmia or sudden death, as compared with 21 of the 32 patients (66 percent) with arrhythmia that continued to be inducible (P less than 0.001). However, effective suppression of inducible arrhythmia by antiarrhythmic drugs was associated with a better outcome than was lack of suppression. content.nejm.org /cgi/content/short/327/14/987   (945 words)

Drug Development Technology - Dronedarone Investigational Agent for the Treatment of Cardiac Arrhythmia Dronedarone is a new Class III antiarrhythmic drug under development by Sanofi-Aventis (formerly Sanofi-Synthlelabo) for the prevention of cardiac arrhythmias. The drug is currently in advanced-stage development for prevention and treatment of atrial fibrillation (AF), its initial indication. Drugs with a class III mechanism of action are seen as the most promising area of research for improved pharmacotherapy of AF, with several new agents in addition to dronedarone in development. www.drugdevelopment-technology.com /projects/Dronedarone   (823 words)

Antiarrhythmic Drugs The drugs were used to suppress asymptomatic premature ventricular depolarizations in patients with recent prior myocardial infarctions at moderate risk for for sudden death. Drugs within a class are not necessarily clinically similar: a patient may respond well to one drug in a given class, but not another. Antiarrhythmic drug therapy is rarely indicated in patients with benign arrhythmias except to relieve debilitating symptoms (e.g. www.md.huji.ac.il /mirror/netpharm/arrhythm.htm   (2304 words)

II. SELECTION OF AN ANTIARRHYTHMIC DRUG Selection of a drug in a complicated arrhythmia is   (Site not responding. Last check: 2007-09-30) SELECTION OF AN ANTIARRHYTHMIC DRUG Selection of a drug in a complicated arrhythmia is often difficult because of the lack of knowledge regarding the exact mechanism of the arrhythmia. Choice of an agent may be aided or narrowed by testing the candidate drugs with programmed electrical stimulation (PES) in the clinical electrophysiology laboratory, or with prolonged (48 hr) Holter monitoring; by knowledge of prior efficacy of a drug in that patient; by presence of nodal dysfunction; and by presence of congestive heart failure. If drugs are ineffective or not tolerated, surgical procedures, antitachycardia pacing, or catheter ablation procedures may be considered. www.skepticfiles.org /md001/select3.htm   (774 words)

Class IC antiarrhythmic drug induced atrial flutter: electrocardiographic and electrophysiological findings and their ... Class IC antiarrhythmic drug induced atrial flutter: electrocardiographic and electrophysiological findings and their importance for long term outcome after right atrial isthmus ablation -- Nabar et al. Class IC antiarrhythmic drug induced atrial flutter: electrocardiographic and electrophysiological findings and their importance for long term outcome after right atrial isthmus ablation Radiofrequency ablation of atrial flutter due to administration of class IC antiarrhythmic drugs for atrial fibrillation. heart.bmjjournals.com /cgi/content/full/85/4/424   (3119 words)

antiarrhythmic drug use: limitations Over one-third of patients with new-onset AF received antiarrhythmic drugs despite the presence of contraindications or warnings. Although such restrictions may not preclude the use of these drugs, the results demonstrate the need for new antiarrhythmic drugs with fewer limitations." CMAJ =B7 September 28, 2004; 171 (7). Drugs like beta blockers are have their own dangers. www.pahealthsystems.com /message119327.html   (1165 words)

Evaluation of Ibutilide Fumarate (Corvert®) Close monitoring of the QRS duration must be done during administration of a class Ic antiarrhythmic drug because these drugs induce broadening of the QRS complex due to a decrease in the conduction velocity. Generally, drugs that prolong the QT interval increase progressively the risk of torsades de pointes as the QT interval is prolonged. Class Ia antiarrhythmic drugs (Vaughan Williams Classification) such as disopyramide, quinidine, and procainamide, and other class III drugs such as amiodarone and sotalol should NOT be given concomitantly with ibutilide or within 4 hours post infusion because of their potential to prolong refractoriness. acc-www.uchicago.edu /drug/Bulletins/N0898.html   (3334 words)

Antiarrhythmic Dofetilide May Also Help In Congestive Heart Failure   (Site not responding. Last check: 2007-09-30) The drug, dofetilide, is a class III antiarrhythmic drug normally used to treat tachyarrhythmia, a condition that causes the heart to beat so fast that it can’t pump blood effectively. The drugs have sometimes resulted in an increased occurrence of irregular heartbeats or arrhythmias. "Prolonged QT interval is a cause for caution when using antiarrhythmic drugs because the drug could further prolong the QT interval and cause a deadly arrhythmia," says Dr. Brendorp, a clinical researcher in cardiology at Copenhagen University Hospital in Gentofte, Denmark. www.pslgroup.com /dg/1f4c86.htm   (835 words)

Risk of Initiating Antiarrhythmic Drug Therapy for Atrial Fibrillation in Patients Admitted to a University Hospital -- ... Risk of Initiating Antiarrhythmic Drug Therapy for Atrial Fibrillation in Patients Admitted to a University Hospital -- Maisel et al. Antiarrhythmic drug therapy and cardiac mortaity in atrial fibrillation. Effects of advancing age on the efficacy and side effects of antiarrhythmic drugs in post-myocardial infarction patients with ventricular arrhythmias. www.annals.org /cgi/content/full/127/4/281   (2281 words)

[No title]   (Site not responding. Last check: 2007-09-30) In 9 of these patients (group 1A), sustained VT was suppressed with class IA antiarrhythmic drugs; in the remaining 30 patients (group 1B) sustained VT was not suppressed with class IA antiarrhythmic drugs. Selected therapy in group 1 was an implantable cardioverter defibrillator (16 patients) or guided drug therapy (electrophysiologically guided class I antiarrhythmic drugs = 7 patients; Holter-guided class III antiarrhythmic drugs = 16 patients). The following conclusions can be drawn from this analysis: (1) Electrophysiologically guided drug therapy and implantable defibrillators can minimize the risk of sudden cardiac death in patients with coronary artery disease and inducible sustained VT stratified to higher risk of sudden death. www.elsevier.com /cdweb/journals/00029149/articles/80/5/S000291499700478.abstract.en   (455 words)

Limitations to antiarrhythmic drug use in patients with atrial fibrillation -- Humphries et al. 171 (7): 741 -- ... Limitations to antiarrhythmic drug use in patients with atrial fibrillation -- Humphries et al. Limitations to antiarrhythmic drug use in patients with atrial fibrillation Antiarrhythmic drug therapy in the treatment of atrial fibrillation. www.cmaj.ca /cgi/content/full/171/7/741   (2123 words)

JAMA -- Abstract: Effects of prophylactic antiarrhythmic drug therapy in acute myocardial infarction. An overview of ...   (Site not responding. Last check: 2007-09-30) Effects of prophylactic antiarrhythmic drug therapy in acute myocardial infarction. antiarrhythmic agents on mortality in patients with myocardial infarction. Is hospital admission for initiation of antiarrhythmic therapy with sotalol for atrial arrhythmias required?: yield of in-hospital monitoring and prediction of risk for significant arrhythmia complications jama.ama-assn.org /cgi/content/abstract/270/13/1589   (864 words)

Clinical Trial: Radiofrequency Ablation (RFA) Versus Antiarrhythmic Drug Treatment in Paroxysmal Atrial Fibrillation The present study is a prospective, randomized, multicentre study comparing medical antiarrhythmic drug strategy with catheter based radiofrequency strategy in patients with paroxysmal atrial fibrillation. Pulmonary vein isolation by transvenous radiofrequency ablation is superior to present time antiarrhythmic drug therapy with regard to long-term suppression of atrial fibrillation (symptomatic and asymptomatic) as well as to procedure/treatment related side effects. Patients ≤ 70 years of age and with paroxysmal atrial fibrillation who are considered as being candidates for antiarrhythmic drug therapy initiation and who have had at least two episodes of symptomatic paroxysmal atrial fibrillation in the foregoing 6 months can be included. www.clinicaltrials.gov /ct/show/NCT00133211   (1033 words)

Relative Role of Alkalosis and Sodium Ions in Reversal of Class I Antiarrhythmic Drug—Induced Sodium Channel Blockade ... Alkalinization caused a 4- to 5-mV hyperpolarization of the In the absence of the drug, alkalinization caused Blockade of cardiac sodium channels: competition between the permeant ion and antiarrhythmic drugs. circ.ahajournals.org /cgi/content/full/94/8/1954   (4209 words)

Antiarrhythmic Drug Target Choices and Screening -- Sanguinetti and Bennett 93 (6): 491 -- Circulation Research A theoretical drug is antiarrhythmic (prevents VF) by reducing dynamic instability (eg, APD restitution [APDR]) from point a to point b. that not all drugs that prolong QT cause arrhythmias. A comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. circres.ahajournals.org /cgi/content/full/93/6/491   (6304 words)

PharmGKB: Antiarrhythmic Drug Pathways   (Site not responding. Last check: 2007-09-30) Pharmacodynamic pathway of antiarrhythmic drugs in a stylized cardiac myocyte. Drugs are used to suppress abnormalities of cardiac rhythm, and antiarrhythmic (and other) drugs can occasionally exacerbate arrhythmias. Most available drugs exert these beneficial or adverse effects by inhibiting one or more of the specific processes shown above. www.pharmgkb.org /search/pathway/antiarrhythmic/antiarrhythmic.jsp   (380 words)

Amiodarone: Reevaluation of an Old Drug -- Podrid 122 (9): 689 -- Annals of Internal Medicine The drug interferes with the conversion of thyroxine Significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy. Randomized antiarrhythmic drug therapy in survivors of cardiac arrest (the CASCADE Study). www.annals.org /cgi/content/full/122/9/689   (8220 words)

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