Editorial: Rise and Fall of Guided Antiarrhythmic Therapy for Ventricular Tachycardia and Fibrillation

Singh, Bramah N.

doi:10.1177/107424849600100201

Cited by 5 publications

(1 citation statement)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An unusually high degree of antiarrhythmic efficacy, particularly in the case of AF [13••,14•] A very low proclivity to induce proarrhythmic reactions despite its significant Class I actions and the marked tendency to produce QT/QTc prolongation [17,18] A powerful suppressant effect on premature ventricular contraction with a low efficacy for the prevention of ventricular tachycardia/ventricular fibrillation induced by programmed electrical stimulation [19] A striking difference between the acute and chronic pharmacologic and therapeutic effects not readily accounted for by the differences in drug plasma, tissue, or membrane levels [20] An exceedingly long and variable plasma elimination half-life and even longer therapeutic half-life with a slow onset and offset of electrophysiologic and therapeutic actions [21] 1.…”

Section: Synthesis and Development Of Amiodaronementioning

confidence: 99%

Amiodarone: A multifaceted antiarrhythmic drug

Singh

2006

Curr Cardiol Rep

Self Cite

View full text Add to dashboard Cite

Synthesized as an antianginal compound 40 years ago, amiodarone has emerged as a uniquely effective antiarrhythmic compound in recent years. It has numerous properties, the most prominent being the ability to lengthen repolarization in the atria and ventricles associated with bradycardia without the significant potential for torsades de pointes. Amiodarone effectively controls a wide spectrum of atrial and ventricular antiarrhythmic disorders, but its limiting side effects, such as thyroid dysfunction, pulmonary fibrosis, and dermatologic changes, may limit its long-term use in some patients. What aspects of the multiplicity of the properties of amiodarone are relevant to its unusual efficacy is not known. Deiodination and other structural changes in the amiodarone molecule have has led to a the loss of thyroid and pulmonary effects in the resulting derivative, dronedarone, which is in advanced clinical development.

show abstract

Section: Synthesis and Development Of Amiodaronementioning

confidence: 99%

Amiodarone: A multifaceted antiarrhythmic drug

Singh

2006

Curr Cardiol Rep

Self Cite

View full text Add to dashboard Cite

show abstract

Overview of trends in the control of cardiac arrhythmia: past and future

Singh

1999

The American Journal of Cardiology

View full text Add to dashboard Cite

Untitled

Singh

2002

Heart Failure Reviews

View full text Add to dashboard Cite

A wide spectrum of ventricular and supraventricular tachyarrhythmias occurs in the setting of congestive cardiac failure. However, the two most clinically significant are atrial fibrillation and ventricular tachycardia and fibrillation. In the past there has been much emphasis on premature ventricular contractions and more recently, on nonsustained ventricular tachycardia. For the most part, these arrhythmias are asymptomatic in heart failure. They are markers of sudden arrhythmic death but their suppression by antiarrhythmic drugs have not resulted in a reduction of total mortality. Two approaches have been used to this end. The first is the use of beta-adrenergic blocking drugs and antiarrhythmic agents such as amiodarone. Beta-blockers have been shown to significantly reduce sudden death as well as total mortality, while the effects of amiodarone have been less decisive. The prospective role of the implantable cardioverter defibrillator (ICD) is undergoing critical evaluation in patients with cardiac failure at high risk for sudden death. The elective role of the ICD is well established as first-line therapy in patients with heart failure resuscitated from sudden death and in those with sustained ventricular tachycardia in conjunction with conventional therapies for cardiac decompensation. The prevalence of atrial fibrillation rises as a function of severity of cardiac failure, but it is also in known that persistent atrial fibrillation with an uncontrolled ventricular response may induce heart failure. Controlled ventricular response may prevent congestive heart failure and improve left ventricular function. The two most common causes of atrial fibrillation in cardiac failure in Europe and America are ischemic heart disease and hypertension, while mitral valve disease remains the prevalent cause elsewhere. The choice of antiarrhythmic drugs for maintaining sinus rhythm is critical in the prevention of heart failure aggravation and proarrhythmic reactions of antiarrhythmic drugs. Amiodarone and dofetilide are most widely used in this context.

show abstract

Editorial: Rise and Fall of Guided Antiarrhythmic Therapy for Ventricular Tachycardia and Fibrillation

Cited by 5 publications

References 19 publications

Amiodarone: A multifaceted antiarrhythmic drug

Amiodarone: A multifaceted antiarrhythmic drug

Overview of trends in the control of cardiac arrhythmia: past and future

Untitled

Contact Info

Product

Resources

About