[Clinical proarrhythmias induced by anti-arrhythmic drugs, non-cardiovascular agents and implantable cardioverter-defibrillators].
The authors survey the electrophysiological mechanisms and clinical spectrum of the aggravation of cardiac arrhythmias provoked by antiarrhythmic drugs, non-cardiovascular agents and implantable cardioverter-defibrillators. The main aspects of the recognition, the differential diagnostics and the therapy are discussed. It is demonstrated that prevention of drug-induced arrhythmogenesis necessitates a fundamental understanding of the risk factors of proarrhythmias and of the clinical pharmacological properties of the drugs that are intended to be used, including proarrhythmic drug interactions. A systematic account is presented of those drugs prescribed in non-arrhythmic diseases which may lead to out-of-hospital cardiac arrest. The proarrhythmias that may be observed in recipients of implantable cardioverter-defibrillators are discussed, as are the undesirable interactions between these devices and antiarrhythmic drugs in such patients.
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Szegedi Tudományegyetem, Szent-Györgyi Albert Orvos- és Gyógyszerésztudományi Centrum, Altalános Orvostudományi Kar, I. Belgyógyászati Klinika. fat@in1st.szote.u-szeged.hu
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D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D000890:Anti-Infective Agents / Q000009:adverse effects; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005765:Gastrointestinal Agents / Q000009:adverse effects; D006329:Heart Conduction System / Q000187:drug effects; D006634:Histamine H1 Antagonists / Q000009:adverse effects; D006801:Humans; D011619:Psychotropic Drugs / Q000009:adverse effects
D000889:Anti-Arrhythmia Agents; D000890:Anti-Infective Agents; D005765:Gastrointestinal Agents; D006634:Histamine H1 Antagonists; D011619:Psychotropic Drugs