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Antiarrhythmic drugs

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Drugs for Heart Disease

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Abstract

The classification of antiarrhythmic drugs proposed by Vaughan Williams in 1970 [1, 2] has stood the test of time and is widely used as a shorthand expression of drug effect. The four classes, conventionally described by Roman numerals (I–IV) on the basis of effect on action potential (Fig. 1.1), have remained unchanged and although criticized as not clinically relevant seem to describe fundamental ways in which abnormal rhythms can be controlled. Class I has been subdivided (Ia, Ib, Ic) on the perhaps naive basis of the effect of those drugs on action potential duration (APD) [2]. Class V was initiated for a new group of drugs which seemed to slow the rate by an effect on Cl ion currents in the pacemaker [3]. These drugs have not been developed because of toxicity problems. They might have found a place in control of angina but are not truly antiarrhythmic and were described cynically as antiarrhythmic drugs searching for an arrhythmia to treat.

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  1. John Hamer
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  1. Formerly Consultant Cardiologist, now retired, Department of Clinical Pharmacology, St Bartholomew’s Hospital, EC1A 7BE, London, UK

    John Hamer MD. Ph.D F.R.C.P.

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Hamer, J. (1987). Antiarrhythmic drugs. In: Hamer, J. (eds) Drugs for Heart Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-3294-5_1

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  • DOI: https://doi.org/10.1007/978-1-4899-3294-5_1

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