Unmet Medical Needs

The limitations to current therapy arise from many reasons, including incomplete knowledge of normal and arrhythmic electrogenesis. Models of electrogenesis (normal or arrhythmic) are still not truly predictive and we have still to identify specific arrhythmogens (except for catecholamines, potassium, and H +) where blockade of their production could be reasonably expected to prevent arrhythmias.

While molecularly selective blockade can be produced with some drugs, such blockade is only antiarrhythmic under restricted conditions. Excessive ion channel blockade, regardless of the channel blocked, is arrhythmogenic.

In general, current antiarrhythmic drugs lack effectiveness, thereby emphasizing a need for new therapies for arrhythmias, whether these involve drugs or electrical devices. There are efficacy and toxicity limitations with most of the currently available drugs, despite new and improved knowledge of arrhythmias, and new concepts regarding strategies for better therapy. Consequently, there are many areas where treatment is far from ideal. A prime example is a need for prophylactic drug treatment in the prevention of cardiac sudden death due to ventricular fibrillation. Other areas of need include the following conditions.

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