Antiarrhythmics

M J A Walker, University of British Columbia, Vancouver, BC, Canada PPS So, University of Toronto, Toronto, ON, Canada

© 2007 Elsevier Ltd. All Rights Reserved.

6.33.1 Disease States 730

6.33.1.1 Types of Arrhythmias: Characteristics, Prevalence, Demographics, and

Symptoms 730

6.33.1.1.1 Nodal arrhythmias 730

6.33.1.1.2 Atrial arrhythmias 730

6.33.1.1.3 Ventricular arrhythmias 731

6.33.2 Disease Basis 733

6.33.2.1 Cardiac Ion Channels 733

6.33.2.1.1 Sodium channels 735

6.33.2.1.2 Calcium channels 735

6.33.2.1.3 Potassium channels 736

6.33.2.2 Mechanistic Macro Models of Arrhythmias 737

6.33.2.2.1 Ectopic foci 737

6.33.3 Experimental Disease Models 739

6.33.4 Clinical Trial Issues 740

6.33.5 Current Treatments 741

6.33.5.1 Overview of Current Antiarrhythmic Drugs 742

6.33.5.2 Classification Systems for Antiarrhythmic Drugs 742

6.33.5.2.1 Antiarrhythmic classes 1-5: actions, effectiveness, toxicity 742

6.33.5.2.2 Muscarinic receptor blockers 748

6.33.5.2.3 Adenosine 748

6.33.5.2.4 Amiodarone 749

6.33.5.3 Overview of Current Electrical Treatments for Arrhythmias 749

6.33.5.4 Other Therapies for Arrhythmias 749

6.33.6 Unmet Medical Needs 749

6.33.6.1 Atrial Arrhythmias 750

6.33.6.2 Ventricular Arrhythmias 750

6.33.7 New Research Areas 750

6.33.7.1 New Antiarrhythmics (Classes 1-5) 750

6.33.7.2 Antiarrhythmic Drugs Combining Actions of Classes 1-5 753

6.33.7.2.1 Combined class 1b and 3 actions 754

6.33.7.2.2 Combined class 3 and 4 actions 754

6.33.7.2.3 Combined class 1, 3, and 4 actions 755

6.33.7.3 Drugs that Block Other Ion Channels, Pumps, or Transporters 755

6.33.7.3.1 Gap junction activators 755

6.33.7.3.2 Stretch activated channel blockers 755

6.33.7.3.3 Pumps, exchangers, and transporters 755

6.33.7.4 Rational Approaches to New Antiarrhythmic Drugs 756

6.33.7.5 Future Directions 758 6.33.7.5.1 An example of an approach to discovering a new antiarrhythmic drug 758

References 761

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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