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Research Article| Volume 54, ISSUE 4, P8-17, August 13, 1984

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New directions in antiarrhythmic drug therapy

  • John C. Somberg
    Correspondence
    Address for reprints: John Somberg, MD, Cardiology Division, Albert Einstein College of Medicine, Bronx, New York 10461.
    Affiliations
    From the Department of Medicine and Pharmacology and the Cardiac Arrhythmia and Clinical Etectrophysiology Service, Hospital of the Albert Einstein College of Medicine, Bronx, New York USA
    Search for articles by this author
DOI:https://doi.org/10.1016/0002-9149(84)90818-X
New directions in antiarrhythmic drug therapy
Previous ArticlePerspectives on the current treatment of cardiac arrhythmias
Next ArticlePharmacology of lorcainide
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      Abstract

      Cardiac arrhythmia causing sudden cardiac death is a serious worldwide public health problem. Antiarrhythmic agents have been available for therapy, but the conventional agents cause a high degree of intolerable side effects. The recent development of many new experimental antiarrhythmic agents has increased our capacity to effectively treat cardiac arrhythmias. Using a multifaceted approach of programmed electrical stimulation studies, drug level determinations, exercise testing and 24-hour ambulatory Holter monitoring, it can reasonably be decided which patient needs therapy and if therapy is going to be effective. Both aspects of the sudden death equation, ectopy frequency (triggering mechanism) and the ability to propagate sustained ventricular tachycardia (substrate), may be examined. Careful follow-up is needed to determine continued drug efficacy and the presence of side effects that may compromise patient compliance with therapy. If side effects intervene that may cause continued therapy to be intolerable, changing the antiarrhythmic agent, as opposed to decreasing the dosage to an ineffective range, may be appropriate. A comprehensive approach to arrhythmia management may begin to reduce the high incidence of sudden death due to fatal arrhythmias.
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      DOI: https://doi.org/10.1016/0002-9149(84)90818-X

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      © 1984 Published by Elsevier Inc.

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