Antiarrhythmic Drug Therapy: Understanding Options for the Ablationist

2013 ◽  
pp. 191-202
Author(s):  
Arshad Jahangir
Keyword(s):  
Cardiac Arrhythmias ◽  
Drug Disposition ◽  
Antiarrhythmic Agents ◽  
Antiarrhythmic Drug Therapy ◽  
Safe Medication ◽  
Arrhythmia Mechanisms ◽  
Disease Condition ◽  
Prognostic Implications ◽  
Arrhythmia Prevention ◽  
Selection Of

Antiarrhythmic agents play an important role in the management of cardiac arrhythmias as both primary and hybrid therapy. The essential goals of antiarrhythmic therapy are termination of an ongoing arrhythmia, prevention of arrhythmia recurrence, or both. Antiarrhythmic drugs help control arrhythmias but also may cause them. Therefore, selection of an effective yet safe medication may be challenging. The challenge arises from factors intrinsic to the patient, the disease condition, or the drug itself. These factors include variability in the pathophysiologic substrate, arrhythmia mechanisms, clinical presentation, prognostic implications, drug disposition, and response. Patients with arrhythmia comprise a highly heterogeneous patient population, with variable comorbid conditions and concomitant drug use.

Cardiac instability amplified by use-dependent Na channel blockade

1992 ◽  
Vol 262 (4) ◽  
pp. H1305-H1310 ◽  
Author(s):  
C. F. Starmer ◽  
A. R. Lancaster ◽  
A. A. Lastra ◽  
A. O. Grant
Keyword(s):  
Sudden Death ◽  
Cardiac Arrhythmias ◽  
Tricyclic Antidepressants ◽  
Spatial Dispersion ◽  
Na Channel ◽  
Antiarrhythmic Agents ◽  
Channel Blockade ◽  
Vulnerable Period ◽  
Conditioning Stimuli ◽  
Increased Susceptibility

Drugs that exhibit use-dependent Na channel blockade, including antiarrhythmic agents, tricyclic antidepressants, opiate-like analgesics, and cocaine, are linked with an increased susceptibility to cardiac arrhythmias and sudden death. Computer simulations indicate that Na channel blockade retards recovery of excitability, thereby increasing the spatial dispersion of refractoriness, a precursor of many cardiac arrhythmias. In isolated rabbit left atria, stimuli timed to occur at increasing intervals following conditioning stimuli reveal an unstable interval (vulnerable period) during which single stimuli initiate trains of responses. The vulnerable period is extended by use-dependent Na channel blockade and provides a model for assaying proarrhythmic potential and probing cardiac instability.

scholarly journals Why and How Should We Integrate Biomarkers into Complex Trials? A Discussion on Paradigms and Clinical Research Strategies

2019 ◽  
Vol 26 (5) ◽  
pp. 343-352
Author(s):  
Frauke Musial ◽  
Scott Mist  ◽  
Sara Warber ◽  
Mary Jo Kreitzer ◽  
Cheryl Ritenbaugh ◽  
...  
Keyword(s):  
Expert Panel ◽  
Complex Interventions ◽  
Research Approach ◽  
Research Strategies ◽  
Disease Condition ◽  
Nonspecific Factors ◽  
Multiple Symptoms ◽  
The Relationship ◽  
Selection Of ◽  
Complementary And Alternative

Background: Research in complementary and alternative medicine (CAM) encounters a variety of challenges, such as potentially synergistic, multimodal, and complex interventions which are often dependent on the relationship between practitioner and patient, on specific settings, and on patients’ individual preferences, expectations, beliefs, and motivations. Moreover, patients seeking CAM care often suffer from chronic disease conditions, and multiple symptoms and/or pathologies. On the other hand, CAM interventions are often challenged as being solely dependent on subjective and nonspecific factors without biologically based mechanisms of action. If we agree that biomarkers as outcomes are important for the understanding of CAM interventions, a hypothesis- and strategy-driven process for the selection of the most appropriate biomarkers is needed. Methods: This paper presents the results of an expert panel on how to integrate biomarkers in whole system research of an interdisciplinary workshop on research methodology in CAM held in November 2012. Results: The following main CAM research challenges were identified: (a) finding appropriate biomarkers, which are able to picture the complex pathophysiological pathways and likewise complex interventions under study; (b) integrating these biomarkers into clinical trials in CAM; and (c) identifying the biomarkers specific to the particular CAM intervention being applied. Conclusion: The paper provides a disease/condition/symptom- and intervention-driven strategy regarding how to identify the outcomes of interest and possible related biomarkers. The research approach presented here allows the selected biomarkers to be grounded in conventional physiology/pathophysiology as well as complementary and alternative concepts, including traditional systems of medicine. The goal is to provide researchers in the field with a framework on how to integrate biomarkers into complex trials.

scholarly journals Influence of Antiarrhythmic Agents on Calcium-Induced Cardiac Arrhythmias in the Rat

1955 ◽  
Vol 3 (5) ◽  
pp. 474-477 ◽  
Author(s):  
MARTIN M. WINBURY ◽  
MIRIAM L. HEMMER
Keyword(s):  
Cardiac Arrhythmias ◽  
Antiarrhythmic Agents

COVID-19 and Homoeopathic Intervention- A Case Report

2020 ◽  
Vol 9 (1) ◽  
pp. 602-608
Author(s):  
Partha Pratim Pal ◽  
Keyword(s):  
Case Report ◽  
Molecular Level ◽  
Treatment Method ◽  
Rt Pcr ◽  
International Crisis ◽  
Global Pandemic ◽  
Positive Individual ◽  
Disease Condition ◽  
Methods Of Treatment ◽  
Selection Of

Studies are going worldwide to develop an effective method for treatment against the global pandemic of COVID-19 but unfortunately no treatment method has been declared as a specific therapeutic approach against COVID-19. History stands as evidence where homeopathy intervention has been beneficial in both preventive and curative aspects of various epidemics. Holistic symptomatological aspect based on generalities enables Homeopathy to be effective in any disease condition. Selection of homeopathic remedy is always on basis of the totality of symptoms and in most cases the changes occurring in cellular and molecular level are not required except in few occasions of dose and potency determination. This concept of healing through homoeopathy is different from other conventional methods of treatment where molecular pathogenesis is the fulcrum of the drug protocols. Hence, in the era of fight to discover vaccine against COVID-19, the following case report shows how a COVID-19 positive individual with mild symptomatology of vomiting, fever, malaise, heaviness of head and loss of taste, recovers with prescription of Bryonia alba 200, followed by Tuberculinum 200, 1M and 10M and at the same time RT-PCR for SARS-CoV-2 becomes negative in the duration of two weeks. Therefore, this case report demonstrates why Homoeopathic intervention should be emphasized in the management of this international crisis. Keywords Coronavirus disease; Bryonia; Tuberculinum; RT-PCR

Cardiac Arrhythmias in Patients with Chronic Kidney Disease: Implications of Renal Failure for Antiarrhythmic Drug Therapy

2016 ◽  
Vol 23 (19) ◽  
pp. 2070-2083 ◽  
Author(s):  
Tatjana S. Potpara ◽  
Vera Jokic ◽  
Nikolaos Dagres ◽  
Francisco Marin ◽  
Milica S. Prostran ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Drug Therapy ◽  
Kidney Disease ◽  
Antiarrhythmic Drug ◽  
Cardiac Arrhythmias ◽  
Antiarrhythmic Drug Therapy

Heart rate variability: prognostic implications

1994 ◽  
Vol 3 (6) ◽  
pp. 476-480 ◽  
Author(s):  
LG Futterman ◽  
L Lemberg
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Arrhythmias ◽  
Cardiac Death ◽  
Autonomic Function ◽  
Management Strategies ◽  
Disease Process ◽  
Hrv Analysis ◽  
Prognostic Implications ◽  
Long Term Studies

HRV offers information about sympathetic and parasympathetic autonomic function and thus can serve as a measure of risk stratification for serious cardiac arrhythmias and sudden cardiac death. HRV appears to be altered in patients with acute myocardial infarction or diabetic neuropathy and is affected by other physiologic and pathophysiologic processes. Use of HRV measurements requires continued investigation to determine optimal methods and tools by which HRV indices and its variables are analyzed. Long-term studies are required to help correct for differences in values pertaining to age and disease process. Also, studies are needed to determine how patient management strategies will be affected by knowledge gained through HRV analysis and to determine which patient populations should be monitored for HRV analysis and to identify those at risk for sudden cardiac death.

scholarly journals Mutations in MPNs: prognostic implications, window to biology, and impact on treatment decisions

Hematology ◽  
2016 ◽  
Vol 2016 (1) ◽  
pp. 552-560 ◽  
Author(s):  
Jamile M. Shammo ◽  
Brady L. Stein
Keyword(s):  
Essential Thrombocythemia ◽  
Somatic Mutations ◽  
Myeloproliferative Neoplasms ◽  
Jak2 V617f ◽  
Molecular Profiling ◽  
Disease Pathogenesis ◽  
Diagnostic Capability ◽  
Impact On Treatment ◽  
Prognostic Implications ◽  
Selection Of

The last decade has witnessed tremendous scientific advances, ushered in by the JAK2 V617F discovery, contributing to enhanced diagnostic capability and understanding of the biology of myeloproliferative neoplasms (MPNs). Discovery of the calreticulin mutations filled a diagnostic gap; more recent work sheds light on its contribution to disease pathogenesis, and prognosis. Recent studies have also identified novel JAK2 and MPL mutations in patients with essential thrombocythemia and myelofibrosis (MF). Especially in MF, the driver mutational profile has prognostic implications, with additive contributions from the acquisition of additional somatic mutations. The hope is that sophisticated molecular profiling will not only aid in prognostication, but also guide selection of therapy for patients with MPNs.

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