title: [Antiarrhythmic therapy in the elderly].
abstract: It has been widely recognized that the elderly shows an increased prevalence of cardiac arrhythmias. Moreover, the elderly population presents a number of problems to the clinician prescribing antiarrhythmics, such as drug accumulation, low compliance and proarrhythmias. In this article, we discussed age-related changes of the pharmacokinetics and the pharmacodynamics of antiarrhythmics with reference to proarrhythmia in the elderly. Age-dependent decrease of renal creatinine clearance plays an important role in the pharmacokinetics in the elderly. Age-related changes of pharmacodynamics of antiarrhythmics have not been evaluated extensively. Our results concerning the effect of class 1a drug on filtered QRS width on signal-averaged ECG, demonstrated age-related accentuation of class 1 action. In terms of non-pharmacologic treatment, physiological pacing is useful especially on elderly patients. The indications for catheter ablation and implantable cardiverter-defibrillators for the elderly should be established in detail.
authors.affiliation: First Department of Internal Medicine, Nippon Medical School.
authors.forename: H
authors.initials: H
authors.lastname: Hayakawa
authors.forename: T
authors.initials: T
authors.lastname: Ino
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D006801:Humans
chemical_list: D000889:Anti-Arrhythmia Agents