Pharmacological Therapy of Cardiac Arrhythmias: Antiarrhythmic Agents, Beta Adrenoceptor Blocking Agents, and Digitalis Glycosides



The ideal approach to the management of cardiac rhythm disorders depends on the following:
  1. 1.

    Proper identification of the arrhythmia.

  2. 2.

    An understanding of the natural history of the arrhythmia in a particular patient.

  3. 3.

    An understanding of the multiple factors that may precipitate and maintain a cardiac rhythm disturbance in a particular patient.

  4. 4.

    An understanding of the pharmacology of the numerous antiarrhythmic drugs available.

  5. 5

    An appropriate clinical assessment of the risk to the patient due to the cardiac arrhythmia versus the side effects that might ensue upon initiation of treatment with an antiarrhythmic drug.



Antiarrhythmic Drug Hepatic Blood Flow Antiarrhythmic Agent Cardiac Glycoside Digitalis Glycoside 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dreifus LS, Ogawa S: Quality of the ideal anti-arrhythmic drug. Am J Cardiol 39: 466–468, 1977.PubMedCrossRefGoogle Scholar
  2. 2.
    Zipes DP: Management of cardiac arrhythmias. In Heart disease. A textbook of cardiovascular medicine, 2nd ed, Braunwald E, (ed), Philadelphia, WB Saunders, 1984, pp 648–682.Google Scholar
  3. 3.
    Woosley RL, Shand DG: Pharmacokinetics of antiarrhythmic drugs. Am J Cardiol 41: 986–995, 1978.PubMedCrossRefGoogle Scholar
  4. 4.
    Bigger JT: Management of arrhythmias. In Heart disease. A textbook of cardiovascular medicine. Braunwald E (ed), Philadelphia, WB Saunders, 1980, pp 691–743.Google Scholar
  5. 5.
    Giardina E-GV, Heissenbuttel RH, Bigger JT: Intermittent intravenous procaineamide to treat ventricular arrhythmias. Ann Intern Med 78: 183–193, 1973.PubMedGoogle Scholar
  6. 6.
    Zipes DP, Troup PF: New antiarrhythmic agents: amiodarone, aprindine, disopyramide, ethmozin, mexiletine, tocainide, verapamil. Am J Cardiol 41: 1005–1024, 1978.PubMedCrossRefGoogle Scholar
  7. 7.
    Singh BN, Collett JT, Chew CY: New perspectives in the pharmacologic therapy of cardiac arrhythmias. Progr Cardiovasc Dis 22: 243–301, 1980.CrossRefGoogle Scholar
  8. 8.
    Anderson JL, Harrison DC, Meffin PJ, Winkle RA: Antiarrhythmic drugs: Clinical pharmacology and therapeutic uses. Drugs 15: 271–309, 1978.PubMedCrossRefGoogle Scholar
  9. 9.
    Velebit V, Podrid P, Lown B, Cohen BH, Graboys TB: Aggravation and provocation of ventricular arrhythmias by antiarrhythmic drugs. Circulation 65: 886–894, 1982.PubMedCrossRefGoogle Scholar
  10. 10.
    Frishman WH: β-Adrenoceptor antagonists. New drugs and new indications. N Engl J Med 305:500, 1981.Google Scholar
  11. 11.
    Frishman WH: The beta-adrenoceptor blocking drugs. Int J Cardiol 2: 165–178, 1982.PubMedCrossRefGoogle Scholar
  12. 12.
    Koch-Weser J: Metoprolol. N Engl J Med 301:698, 1979.Google Scholar
  13. 13.
    Frishman W: Clinical pharmacology of the new 1-adrenergic blocking drugs. Part 1. Pharmaco-kinetic and pharmacodynamic properties. Am Heart J 97:663, 1979.Google Scholar
  14. 14.
    Connolly ME, Kersting F, Dollery CT: The clinical pharmacology of β-adrenoeeptor blocking drugs. Progr Cardiovasc Dis 19:203, 1976.Google Scholar
  15. 15.
    Frishman W, Halprin S: Clinical pharmacology of the new β-adrenergic blocking drugs. Part 7. New horizons in β-adrenoeeptor blocking therapy: labetalol. Am Heart J 98:660, 1979.Google Scholar
  16. 16.
    McDevitt DG: Drug interactions involving β-adrenoceptor blocking drugs. In Cardiovascular and respiratory disease therapy Petri JC, (ed), Amsterdam, Elsevier/North Holland, 1980, pp 21–41.Google Scholar
  17. 17.
    Smith TW, Amman EM, Friedman PL, Blatt CM, Marsh JD: Digitalis glycosides: Mechanisms and manifestations of toxicity. Progr Cardiovasc Dis 26:413, 1984.Google Scholar
  18. 18.
    Hoffman BF, Bigger JT: Digitalis and allied cardiac glycosides. The pharmacological basis of therapeutics, 6th ed, Gilman AG, Goodman LS, Gilman A (eds), New York, MacMillan 1980, pp 729–760Google Scholar
  19. 19.
    Smith TW, Braunwald E: The management of heart failure. In Heart disease. A textbook of cardiovascular medicine, Braunwald E (ed), Philadelphia, WB Saunders, 1980, pp 509–570.Google Scholar
  20. 20.
    Greenblatt DJ, Duhme DW, Koch-Weser J: Pain and CPK elevation after intramuscular digoxin. N Engl J Med 288:689, 1973.Google Scholar
  21. 21.
    Cogan JJ, Humphreys MH, Carlson CJ, et al: Acute vasodilator therapy increases renal clearance of digoxin in patients with congestive heart failure. Circulation 64: 973–976, 1981.PubMedCrossRefGoogle Scholar
  22. 22.
    Lindenbaum J, Rund DG, Butler VP, et al: Inactivation of digoxin by the gut flora: Reversal by antibiotic therapy. N Engl J Med 305: 789–794, 1981.PubMedCrossRefGoogle Scholar
  23. 23.
    Bigger JT: The quinidine-digoxin interaction. Int J Cardiol 1: 109–116, 1981.PubMedCrossRefGoogle Scholar
  24. 24.
    Goldfinger SE: Dissimilarities of digoxin. N Engl J Med 285: 1376–1377, 1971.PubMedCrossRefGoogle Scholar
  25. 25.
    Smith TW, Haber E, Yeatman L, et al: Reversal of advanced digoxin intoxication with Fab fragments of digoxin-specific antibodies. N Engl J Med 294: 797–800, 1976.PubMedCrossRefGoogle Scholar

Copyright information

© Martinus Nijhoff Publishing, Boston. 1986

Authors and Affiliations

  1. 1.Cardiovascular DivisionBrigham and Women’s HospitalBostonUSA
  2. 2.CardiologistGreen Lane HospitalAucklandNew Zealand

Personalised recommendations