The Second Edition of this valuable reference responds to changes in the available medications as well as in the way they are currently used. The book reviews everything you need to understand and prescribe today s antiarrhythmic drugs: mechanisms of cardiac If you prescribe for patients with arrhythmias, you will want to keep this valuable paperback close at hand. The book reviews everything you need to understand and prescribe today s antiarrhythmic drugs: mechanisms of cardiac arrhythmias and how antiarrhythmic drugs alter those arrhythmias, including common adverse effects which factors to consider in using these drugs for treatment of supraventricular tachyarrhythmias, ventricular arrhythmias, and arrhythmias in pregnancy a detailed review of atrial fibrillation to help you make decisions for patient management in this complicated area Dr. Fogoros considers all the most recent drugs, plus promising drugs under investigation, to give you a full picture of therapeutic options.
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These medications are called antiarrhythmic drugs. The major antiarrhythmic drugs those in Class I and Class III , can often produce side effects that outweigh their potential benefits.
What Do Antiarrhythmic Drugs Do? The electrical impulse and the heart beat. The electrical impulse of the heart is generated by the flow of ions charged particles back and forth across the membranes of cardiac cells. The flow of ions, in turn, is controlled by various channels in the cell membrane, that open and close in an organized fashion. As the heart cells depolarize, they contract — and the heart beats. The spread of the electrical signal across the heart is carefully organized in order to produce an effective and efficient heart beat.
Antiarrhythmic drugs. There are many of these drugs, and each of them has a unique side effect profile — so make sure you are aware of the potential side effects of the particular antiarrhythmic drug your doctor is recommending.
But you also need to be aware that there is a potential side effect that many of these drugs share — proarrhythmia, which is the tendency to make arrhythmias worse instead of better. While it may seem paradoxical that drugs that are meant to suppress arrhythmias can actually potentiate them, if you understand how these drugs work this phenomenon is actually predictable.
There are two general mechanisms of proarrhythmia. First, antiarrhythmic drugs can make reentrant arrhythmias more likely to occur. These drugs work by changing the characteristics of the cardiac electrical signal, and in treating reentrant arrhythmias the idea is to change the signal in such a way as to make reentry less likely to occur.
But sometimes the change in the electrical signal caused by the drug will make reentry more likely to occur. Some people are susceptible to dangerous arrhythmias when their QT intervals are prolonged, and several antiarrhythmic drugs actually work by prolonging the QT intervals.
The phenomenon of proarrhythmia makes doctors relatively reluctant to prescribe antiarrhythmic drugs unless the potential benefits greatly outweigh these and other risks. When these drugs are used, doctors need to take every available precaution to prevent harm from being done. How Antiarrhythmic Drugs Are Classified Antiarrhythmic drugs are classified according to their specific effects on the various kinds of channels in the cardiac cell membrane that control the flow of ions.
These drugs are currently classified into 5 catetories: Class 0 to Class IV. Notably, ivabradine does not appear to cause proarrhythmia. These drugs are most often used in treating reentrant arrhythmias, but because they can produce both kinds of proarrhythmia their usage has fallen off over the past decade or two. The class I drugs include: Disopyramide.
Drugs that Treat Cardiac Arrhythmias
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Allow the atrial fibrillation to persist while controlling the heart rate Given these two options, without knowing anything more, almost anyone would start out preferring the rhythm control approach. However, in actual practice, this approach often turns out to be less effective and less safe than the rate control approach. The reason the rhythm control strategy is often a problem is that antiarrhythmic drugs are usually necessary for restoring and maintaining normal heart rhythm. Note that in some patients, getting rid of the atrial fibrillation with an ablation procedure is feasible. The thing that is especially concerning about antiarrhythmic drugs is their unique toxicity, which often makes them difficult and relatively risky to administer and to take. Proarrhythmia "Proarrhythmia" simply means causing cardiac arrhythmias. That is, instead of eliminating arrhythmias, these drugs can actually produce them.
These medications are called antiarrhythmic drugs. The major antiarrhythmic drugs those in Class I and Class III , can often produce side effects that outweigh their potential benefits. What Do Antiarrhythmic Drugs Do? The electrical impulse and the heart beat. The electrical impulse of the heart is generated by the flow of ions charged particles back and forth across the membranes of cardiac cells. The flow of ions, in turn, is controlled by various channels in the cell membrane, that open and close in an organized fashion. As the heart cells depolarize, they contract — and the heart beats.