Antiarrhythmic drug classifications and the clinician: a gambit in the land of chaos.
Several classifications of antiarrhythmic drugs have appeared and all suffer considerable limitations. Recently a Task Force of the Working Group on Arrhythmias of the European Society of Cardiology proposed a novel classification of antiarrhythmic drugs (the so-called Sicilian Gambit) based on their action on the most vulnerable parameter of an arrhythmogenic mechanism. The present article attempts a critical reappraisal of the antiarrhythmic drug actions and the relationship of vulnerable parameters with cellular mechanisms such as ion channels. The clinical applicability of these concepts, the implications of the new classification in the pharmacologic therapy of arrhythmias, and its potential limitations are discussed.
Katritsis
D
D
Department of Cardiological Sciences, St. George's Hospital Medical School, London, England.
Camm
A J
AJ
D000889:Anti-Arrhythmia Agents / Q000145:classification* / Q000494:pharmacology; D006329:Heart Conduction System / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007473:Ion Channels / Q000187:drug effects
D000889:Anti-Arrhythmia Agents; D007473:Ion Channels