Antiarrhythmic therapy in atrial fibrillation

Pharmacology & Therapeutics
U Ravens

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.

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Citations

Dec 17, 2010·Cardiovascular Research·Ursula Ravens, Erich Wettwer
Feb 6, 2014·Herzschrittmachertherapie & Elektrophysiologie·Ursula Ravens
Jun 5, 2013·The Journal of Physiology·Ursula RavensMichael Knaut
Aug 27, 2011·Pharmacology & Therapeutics·Alexander Burashnikov, Charles Antzelevitch
Feb 19, 2011·The Canadian Journal of Cardiology·Anne M GillisUNKNOWN CCS Atrial Fibrillation Guidelines Committee
Mar 23, 2011·Pharmacology & Therapeutics·Jérôme ThireauSylvain Richard
Feb 22, 2011·Pharmacology & Therapeutics·A J WorkmanA C Rankin
Apr 8, 2016·Nature Reviews. Cardiology·Darae KoIngrid E Christophersen
Oct 25, 2016·Pharmacology & Therapeutics·Ursula Ravens, Katja E Odening
Aug 2, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Håkan WalfridssonLeif Carlsson
Jul 25, 2017·Canadian Journal of Physiology and Pharmacology·Ursula Ravens
Aug 1, 2015·Circulation. Arrhythmia and Electrophysiology·James A ReiffelUNKNOWN HARMONY Investigators*
Feb 19, 2021·Frontiers in Pharmacology·Diana AlvaradoGerardo Corzo
Apr 4, 2021·International Journal of Molecular Sciences·Héctor Godoy-MarínFrancisco Ciruela

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