Cardiac Arrhythmias and Antiarrhythmic Drugs: Recent Advances in Our Understanding of Mechanism

Abstract

The purpose of this review is to consider our understanding of the mechanisms of action of cardiac antiarrhythmic drugs, as well as the status of our comprehension of arrhythmias and their therapy. The approach will be to review the basis for normal electric activity of the heart, the mechanisms for cardiac arrhythmias, and our understanding of the mechanisms of drug action, and to distill from these strategies for the future. Immediate strategies in the prevention and treatment of life-threatening arrhythmias will most likely continue to make use of catheter and electrically based therapy, but the longterm treatment of large populations of individuals will still require the search for, and testing and administration of, pharmacologic therapy. It is emphasized that simplistic approaches to the solution of the complex problem of arrhythmias and their management of probably continue to cause problems, and that only by mastering the complexities of pathophysiology may success be best assured.