1. Antiarrhythmic therapy in atrial fibrillation.
- Author
-
Ravens U
- Subjects
- Anti-Arrhythmia Agents adverse effects, Arrhythmias, Cardiac genetics, Arrhythmias, Cardiac metabolism, Arrhythmias, Cardiac prevention & control, Atrial Fibrillation genetics, Atrial Fibrillation physiopathology, Atrial Fibrillation prevention & control, Clinical Trials as Topic, Drugs, Investigational, Gap Junctions metabolism, Heart Atria drug effects, Heart Atria metabolism, Heart Atria physiopathology, Humans, Ion Channels metabolism, Ion Channels pharmacology, Anti-Arrhythmia Agents therapeutic use, Arrhythmias, Cardiac drug therapy, Atrial Fibrillation drug therapy
- Abstract
Currently available antiarrhythmic drugs for the management of AF are not sufficiently effective and are burdened with cardiac and extracardiac side effects that may offset their therapeutic benefits. Better knowledge about the mechanisms underlying generation and maintenance of AF may lead to the discovery of new targets for pharmacological interventions. These could include atrial-selective ion channels (e.g. atrial I(Na), I(Kur) and I(K,ACh)), pathology-selective ion channels (constitutively active I(K,ACh), TRP channels), ischemia-uncoupled gap junctions, proteins related to malfunctioning intracellular Ca2+ homeostasis (e.g., "leaky" ryanodine receptors, overactive Na+, Ca2+ exchanger) or risk factors for arrhythmias ("upstream" therapies). The review will briefly summarize the current pathophysiological and therapeutic concepts of AF. A description of recently developed antiarrhythmic drugs and their proposed pharmacological action will follow. The final section will speculate about some putative targets for antiarrhythmic drug action in the context of the remodelled atria., (2010 Elsevier Inc. All rights reserved.)
- Published
- 2010
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