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Author: Admin | 2025-04-28
The possible exception of amiodarone, the most toxic and dangerous of the rhythm control drugs.Antiarrhythmics are not a long-term solution for most people. Be aware that all antiarrhythmics may increase your risk of a life-threatening ventricular arrhythmia.In addition, according to Heart Rhythm Society’s ‘General Approach to the Patient with AF’ Guidelines, “most patients managed using a rhythm control strategy also require medications for rate control”.According to Drs. Irina Savelieva and John Camm of St. George’s University of London, “The plethora of antiarrhythmic drugs currently available for the treatment of A-Fib is a reflection that none is wholly satisfactory, each having limited efficacy combined with poor safety and tolerability.”36Classes of Antiarrhythmic DrugsAntiarrhythmic drugs are grouped in “classes” according to how they work:1. Class I are Sodium Channel Blockers which decrease the speed of electrical conduction in the heart muscle.2. Class II are Beta-Adrenergic or Beta-Blockers which slow down conduction through the heart and make the AV node less sensitive to A-Fib impulses.3. Class III are Potassium Channel Blockers which slow nerve impulses in the heart.4. Class IV are Calcium Channel Blockers which prevent or slow the flow of calcium ions into smooth muscle cells such as the heart. This impedes muscle cell contraction, thereby allowing blood vessels to expand and carry more blood and oxygen to tissues.Here is a list of the more commonly used antiarrhythmic drugs, based on an article by Dr. R. Falk of the Boston University School of Medicine:37Procainamide (Procan SR, Promine, Pronestyl, Procanbid): Slows nerve impulses in the heart and reduces the sensitivity of heart tissue. Not FDA approved for A-Fib. Long-term use associated with lupus. Generally not used as a first-time drug because of bad side effects. Less effective against A-Fib than the other Class 1A drugs Quinidine and Disopyramide.38 (Class 1A drug) (Rerely used today
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