Myocardial repolarization and drugs. Impossibility to predict the dominance of anti-arrhythmic over pro-arrhythmic effects of drugs due to differential and ventricular electrical remodeling.
It is known that application of anti-arrhythmic drugs for the acute treatment of arrhythmias can not only result in successful termination or prevention, but also can lead to unwanted pro-arrhythmic effects. On the basis of two arrhythmias, atrial fibrillation and Torsade de Pointes arrhythmias, we will highlight the relevance of differential atrial and ventricular electrical remodeling to explain the delicate and dynamic balance between anti-arrhythmic efficacy and pro-arrhythmogenic consequences of class III anti-arrhythmic drugs.
Vos
M A
MA
Department of Cardiology, Academic Hospital Maastricht & Cardiovascular Research Institute, Maastricht. m.vos@cardio.azm.nl
Crijns
H J
HJ
D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000503:physiopathology; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D006801:Humans; D010627:Phenethylamines / Q000009:adverse effects / Q000627:therapeutic use; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000139:chemically induced; D016171:Torsades de Pointes / Q000139:chemically induced
D000889:Anti-Arrhythmia Agents; D010627:Phenethylamines; D013449:Sulfonamides; C067192:ibutilide; C063533:dofetilide