Advances in Antiarrhythmic Therapy

THE APPROACH to the management of disorders of cardiac rhythm has undergone major changes in the last ten years.¹,²The early experience with surgery and with pacemakers suggests that these modes of therapy hold much promise; however, it is unlikely that they will have a major appeal for the largest numbers of patients needing antiarrhythmic therapy.¹Drug therapy is therefore likely to remain the mainstay of long-term antiarrhythmic treatment for both supraventricular as well as ventricular tachyarrhythmias. Clinicians have long sought the "ideal" antiarrhythmic agent, one that has a wide spectrum of therapeutic efficacy, is potent, well tolerated by the patient while having little or no side effects, but with pharmacokinetics appropriate for long-term prophylaxis. Although the discovery of such a compound still appears elusive, many new drugs are now being evaluated in the United States.³,⁴Their investigational use is growing, and some are likely to be approved