Investigational pharmacological strategies for atrial fibrillation include atrial-specific ion channel inhibitors, upstream therapies, improved derivatives of older drugs, and gap junction therapy.
Emerging pharmacological therapies for atrial fibrillation aim to improve efficacy and safety by targeting atrial-specific mechanisms and structural remodeling.
Atrial fibrillation (AF) is a growing clinical problem, increasing in prevalence as the population of the United States and countries around the world ages. Intensive research aimed at improving prevention, diagnosis, and treatment of AF is ongoing. Although the use and efficacy of catheter ablation-based approaches in AF treatment have increased significantly in the last decade, pharmacological agents remain the first-line therapy for rhythm management of AF. Currently available anti-AF agents are generally only moderately effective and associated with extracardiac toxicity and/or a risk for development of life-threatening ventricular arrhythmias. Included among current investigational strategies for improving the effectiveness and safety of anti-AF drugs is the development of (1) Agents that produce atrial-specific or predominant inhibition of I(Kur), I(K-ACh), or I(Na); (2) "Upstream therapies" that effect nonion channel targets that reduce atrial structural remodeling, hypertrophy, dilatation, inflammation, oxidative injury, etc; (3) Derivatives of "old" anti-AF drugs with an improved safety pharmacological profile; and (4) Gap junction therapy aimed at improving conduction without affecting sodium channels. This review focuses on new pharmacological approaches under investigation for the treatment of AF.
Burashnikov et al. (Wed,) conducted a review in Atrial fibrillation. New pharmacological approaches was evaluated. Investigational pharmacological strategies for atrial fibrillation include atrial-specific ion channel inhibitors, upstream therapies, improved derivatives of older drugs, and gap junction therapy.
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