Advances in Antiarrhythmic Therapy: Title and subTitle BreakThe Role of Newer Antiarrhythmic Drugs FREE

Koonlawee Nademanee, MD; Bramah N. Singh, MD, PhD, FRCP

[+] Author Affiliations

This article is one of a series sponsored by the American Heart Association.

Reprint requests to the Cardiology Section (691/111E), Wadsworth Veterans Administration Medical Center, Wilshire and Sawtelle boulevards, Los Angeles, CA 90073 (Dr Singh).

JAMA. 1982;247(2):217-222. doi:10.1001/jama.1982.03320270051027

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References

ABSTRACT

ABSTRACT | REFERENCES

THE APPROACH to the management of disorders of cardiac rhythm has undergone major changes in the last ten years.^1,2 The early experience with surgery and with pacemakers suggests that these modes of therapy hold much promise; however, it is unlikely that they will have a major appeal for the largest numbers of patients needing antiarrhythmic therapy.¹ Drug therapy is therefore likely to remain the mainstay of long-term antiarrhythmic treatment for both supraventricular as well as ventricular tachyarrhythmias.

Clinicians have long sought the "ideal" antiarrhythmic agent, one that has a wide spectrum of therapeutic efficacy, is potent, well tolerated by the patient while having little or no side effects, but with pharmacokinetics appropriate for long-term prophylaxis. Although the discovery of such a compound still appears elusive, many new drugs are now being evaluated in the United States.^3,4 Their investigational use is growing, and some are likely to be approved

REFERENCES

ABSTRACT | REFERENCES

Zipes DP: New approaches to antiarrhythmic therapy . N Engl J Med 1981;;304:475-476.

Wellens HJJ: Value and limitations of programmed electrical stimulation of the heart in the study and treatment of tachycardias . Circulation 1978;;57:845-853.

Zipes DP, Troup PJ: New antiarrhythmic agents: Amiodarone, aprindine, disopyramide, ethmozin, mexiletine, tocainide, verapamil . Am J Cardiol 1978;;41:1005-1024.

Singh BN, Collett JT, Chew CYC: New perspectives in the pharmacologic therapy of cardiac arrhythmias . Prog Cardiovasc Dis 1980;; 22:243-301.

Harrison DC, Meffin PJ, Winkle RA: Clinical pharmacokinetics of antiarrhythmic drugs . Prog Cardiovasc Dis 1977;;20:217-242.

Singh BN, Vaughan Williams EM: The effect of amiodarone, a new anti-anginal drug, on cardiac muscle . Br J Pharmacol 1970;;39:657-668.

Nademanee K, Hendrickson JA, Cannom DS, et al: Control of life-threatening ventricular arrhythmias by amiodarone . Am Heart J 1981;; 101:759-768.

Singh BN, Vaughan Williams EM: A fourth class of antiarrhythmic action? Effect of verapamil on ouabain toxicity, on atrial and ventricular intracellular potentials and on other features of cardiac function . Cardiovasc Res 1972;;6:109-119.

Winkle RA, Mason JW, Harrison DC: Tocainide for drug-resistant ventricular arrhythmias: Efficacy, side effects and lidocaine responsiveness for predicting tocainide success . Am Heart J 1980;;100:1031-1036.

Podrid PJ, Lown B: Mexiletine for ventricular arrhythmias . Am J Cardiol 1981;;47:895-902.

Nademanee K, Melmed S, Hendrickson JA, et al: Role of serum T4 and reverse T3 in monitoring antiarrhythmic efficacy and toxicity of amiodarone in resistant arrhythmias . Am J Cardiol 1981;;47:482.

Rosenbaum MB, Chiale PA, Halpern MS: Clinical efficacy of amiodarone as an antiarrhythmic drug . Am J Cardiol 1976;;38:934-944.

Ellrodt G, Chew CYC, Singh BN: Therapeutic implications of slow-channel blockade in cardiocirculatory disorders . Circulation 1980;; 62:669-679.

Singh BN, Ellrodt G, Peter CT: Verapamil: A review of its pharmacological properties and therapeutic uses . Drugs 1978;;15:169-203.

Rinkenberger RL, Prystowsky EW, Heger JJ, et al: Effect of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias . Circulation 1980;;62:996-1010.

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