Title: What is an antiarrhythmic drug? - a new approach to antiarrhythmic therapy
- Krzysztof J. Filipiak, Maciej Niewada
- Review articles
- Polish Journal of Cardiology
- Start page:
- Final page:
- antiarrhythmic drugs
Cardiac arrhythmias are major public health problem for which traditional pharmacological therapies rema-in disappointing. The impressive development of cardiovascular pharmacotherapy and basie science know-ledge caused the inerease of drug armamentarium and our understanding of cardiac arrhythmias. Antiarrhythmic properties of such drugs as: angiotensin-converting enzyme (ACE) inhibitors and - to less extent -aldosterone antagonists are widely discussed. A new approach to antiarrhythmic therapy is based on evidence from clinical trials in which some newagents - not regarded as antiarrythmics untill now - reduced sudden cardiac deaths frequency and cardiac arrhythmias. ACE-inhibitors, for example, reduce the oceurence of atrial fibrillation in post-myocardial infaretion patients with left ventricular dysfunetion, as well as cause the reduetion of sudden cardiac death in some secondary prevention trials. Spironolactone in RALES trial reduced sudden arrhythmic deaths by 20-30%. Some latest evidence suggest potential antiarrhythmic profile of statins. The mentioned actions are briefly disscused in the following paper and the generał discussion of "what is a contemporary antiarrhythmic" is carried out.