title: Selection of an antiarrhythmic drug for a sudden-death-prevention trial.
abstract: Several therapeutic approaches have sought to prevent the occurrence of sudden cardiac death. Many sudden deaths are presumed to be due to an arrhythmia, but the drugs best known for antiarrhythmic activity, the local anesthetic agents, have not been suitable prophylactic agents because of their toxicities and other undesirable pharmacologic characteristics. Several new drugs in this class have been synthesized and are currently being tested for antiarrhythmic activity in clinical trials. One of them may prove to be worthy of a large-scale clinical trial to determine whether chronic arrhythmia suppression reduces the risk of sudden death. The characteristics of the "ideal" antiarrhythmic agent are discussed, and a brief summary of the drugs currently being tested in the United States is presented. The discussion of each drug emphasizes the characteristics that might make it suitable--or unsuitable--for use in a sudden-death trial. Many agents being tested are clearly not satisfactory for such a trial. However, they may be prototypes for an ideal drug or combination of drugs that might yet be developed.
mesh_terms: D000120:Acecainide / Q000627:therapeutic use; D000638:Amiodarone / Q000627:therapeutic use; D000813:Anilides / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001073:Aprindine / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000517:prevention & control; D044482:Benzeneacetamides; D001949:Bretylium Compounds / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003645:Death, Sudden; D016700:Encainide; D005424:Flecainide; D006801:Humans; D007700:Kinetics; D008012:Lidocaine / Q000031:analogs & derivatives / Q000627:therapeutic use; D008801:Mexiletine / Q000627:therapeutic use; D016293:Moricizine; D009025:Morpholines / Q000627:therapeutic use; D010640:Phenothiazines / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D016677:Tocainide; D014700:Verapamil / Q000627:therapeutic use
chemical_list: D000813:Anilides; D000889:Anti-Arrhythmia Agents; D044482:Benzeneacetamides; D001949:Bretylium Compounds; D009025:Morpholines; D010640:Phenothiazines; D010880:Piperidines; D008801:Mexiletine; D016677:Tocainide; D016293:Moricizine; D001073:Aprindine; D000120:Acecainide; D008012:Lidocaine; D014700:Verapamil; D005424:Flecainide; C015970:lorcainide; D000638:Amiodarone; D016700:Encainide