scholarly journals Antiarrhythmic drugs: mechanisms of action, clinical effects, indications for use

2019 ◽  
Vol 26 (2) ◽  
pp. 76-90
Author(s):  
G. M. Solovyan ◽  
T. V. Mikhalieva

The lecture is devoted to one of the most difficult problems of modern cardiology – the use of antiarrhythmic therapy in clinical practice. The basic mechanisms of arrhythmias, aspects of their onset, maintenance and termination are briefly described. The current evidence on the electrophysiological mechanisms of cardiac arrhythmias – re-entry, abnormal impulse formation, and trigger activity – is presented. The article contains information about the remodeling of ion channels properties. The Sicilian gambit is analyzed, in which the mechanisms of arrhythmias are compared to the mechanisms of anti-arrhythmic action of drugs. Classification of anti-arrhythmic drugs, their mechanisms of action, indications and contraindications, side effects, and interaction with other drugs are presented.

ESC CardioMed ◽  
2018 ◽  
pp. 187-195
Author(s):  
Federico Guerra ◽  
Alessandro Capucci

Antiarrhythmic drugs are the cornerstone of supraventricular and ventricular arrhythmias therapy. Despite the increasing interest in invasive and ablative approaches to treating many arrhythmias, such as atrial fibrillation and ventricular tachycardia, antiarrhythmic drugs are still widely used for both acute management and chronic prophylaxis. Unfortunately, many antiarrhythmic drugs currently available have a narrow therapeutic window and many issues regarding potential serious adverse effects, proarrhythmic properties, and multiorgan toxicity. The current Vaughan Williams classification of antiarrhythmic drugs is shown in a table. The aim this chapter is to provide basic information regarding the most used compounds in clinical practice.


2015 ◽  
Vol 29 (1) ◽  
pp. 77-86 ◽  
Author(s):  
Mary H. Parker ◽  
Cynthia A. Sanoski

A role for oral antiarrhythmic drugs (AADs) remains in clinical practice for patients with atrial and ventricular arrhythmias in spite of advances in nonpharmacologic therapy. Pharmacists play a vital role in the appropriate use of AAD dosing, administration, adverse effects, interactions, and monitoring. Pharmacists who are involved in providing care to patients with cardiac arrhythmias must remain updated regarding the efficacy and safety of the most commonly used AADs. This review will address key issues for appropriate initiation and maintenance of commonly selected Vaughan-Williams Class Ic and III agents in the outpatient setting.


Computers ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 82
Author(s):  
Ahmad O. Aseeri

Deep Learning-based methods have emerged to be one of the most effective and practical solutions in a wide range of medical problems, including the diagnosis of cardiac arrhythmias. A critical step to a precocious diagnosis in many heart dysfunctions diseases starts with the accurate detection and classification of cardiac arrhythmias, which can be achieved via electrocardiograms (ECGs). Motivated by the desire to enhance conventional clinical methods in diagnosing cardiac arrhythmias, we introduce an uncertainty-aware deep learning-based predictive model design for accurate large-scale classification of cardiac arrhythmias successfully trained and evaluated using three benchmark medical datasets. In addition, considering that the quantification of uncertainty estimates is vital for clinical decision-making, our method incorporates a probabilistic approach to capture the model’s uncertainty using a Bayesian-based approximation method without introducing additional parameters or significant changes to the network’s architecture. Although many arrhythmias classification solutions with various ECG feature engineering techniques have been reported in the literature, the introduced AI-based probabilistic-enabled method in this paper outperforms the results of existing methods in outstanding multiclass classification results that manifest F1 scores of 98.62% and 96.73% with (MIT-BIH) dataset of 20 annotations, and 99.23% and 96.94% with (INCART) dataset of eight annotations, and 97.25% and 96.73% with (BIDMC) dataset of six annotations, for the deep ensemble and probabilistic mode, respectively. We demonstrate our method’s high-performing and statistical reliability results in numerical experiments on the language modeling using the gating mechanism of Recurrent Neural Networks.


2014 ◽  
Vol 60 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Patrícia do Carmo Silva Parreira ◽  
Lucíola da Cunha Menezes Costa ◽  
Luiz Carlos Hespanhol Junior ◽  
Alexandre Dias Lopes ◽  
Leonardo Oliveira Pena Costa

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