Antiarrhythmics
Rhythm is something you either have or don't have, but when you have it, you have it all over - Elvis Presley
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image by: Dr.G.Bhanu Prakash
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Delayed and indirect effects of antiarrhythmic drugs in reducing sudden cardiac death
Antiarrhythmic drugs (AADs) can be used for acute or chronic therapy to prevent ventricular arrhythmias and SCD. Most commonly, AADs are often used in patients with an ICD who have recurrent ICD shocks due to ventricular arrhythmias. Class I AADs are used in patients with a structurally normal heart and are contraindicated in patients with structural heart disease. β-blockers have been demonstrated to be beneficial in preventing mortality and malignant tachyarrhythmias in postmyocardial infarction and congestive heart failure patients, and in patients who have an ICD. Amiodarone has a neutral effect on mortality, while other class III drugs may increase mortality in certain subgroups of patients.
Resources
Classification of antiarrhythmic agents
One might occasionally hear it being referred to as the "Vaughan and Williams" or "Vaughan-Williams" classification, which is, of course, inaccurate because it is named after Miles Vaughan Williams, the celebrated pharmacologist and ninety-year-old fitness guru. His classification system was first presented in April of 1970, at the Symposium on Cardiac Arrhythmias in Elsinore, Denmark (yes, that Elsinore).
Pharm 101: Antiarrhythmic Agents
Vaughan-Williams classification (four classes). Drugs may have multiple classes of action e.g. amiodarone shares all four classes of action. Certain agents do not fit this classification scheme: Adenosine, Magnesium.
Antiarrhythmic Agents
Indications of, and mechanism of action for, the various classes of antiarrhythmic drugs...
Antiarrhythmic agents
Antiarrhythmic agents are a group of pharmaceuticals that are used to suppress fast rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. While the use of antiarrhythmic agents to suppress atrial arrhythmias (atrial fibrillation and atrial flutter) is still in practice, it is unclear whether suppression of atrial arrhythmias will prolong life,
Antiarrhythmic Drugs For Heart Disease – 2020 Updated
There are many medications in the antiarrhythmic category. To help make things simple, medical professionals and pharmacists follow the Vaughan Williams classification which classifies anti arrhythmic drugs into five different types.
Antiarrhythmic Drugs in Atrial Fibrillation: Is There Still a Role for Rhythm Control?
Despite the fact that AFFIRM and other studies failed to show any apparent benefit from an antiarrhythmic drug-based rhythm control strategy, the lure of sinus rhythm continues to influence practice in the United States, where one or more attempts to restore and maintain sinus rhythm are often implemented before “giving up” and accepting a rate control strategy.
Antiarrhythmic drugs: Pearls for practice
Learn future of AAD...
Phenytoin: an old but effective antiarrhythmic agent for the suppression of ventricular tachycardia
Although used as an AAD from the 1950s to the 1970s, phenytoin has become obsolete in recent decades due to the arrival of newer and less toxic agents.
Ten Pearls for the Use of Antiarrhythmic Drugs for Atrial Fibrillation
In general, AADs should not be started during/following the first AF episode, unless the symptoms are so dramatic that a recurrence could threaten mortality or rapid hospitalization.
Delayed and indirect effects of antiarrhythmic drugs in reducing sudden cardiac death
Antiarrhythmic drugs (AADs) can be used for acute or chronic therapy to prevent ventricular arrhythmias and SCD
StatPearls
The antiarrhythmic medications have typically been categorized according to the Vaughan-Williams (VW) classification system. The system classifies the medications according to the main mechanism of action (although several of the agents retain properties from multiple classes).

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