New antiarrhythmic agents for atrial fibrillation and atrial flutter
New antiarrhythmic agents for atrial fibrillation and atrial flutter
复制标题
DOI：
10.1517/14728214.10.2.311
复制
发表时间：
2005-05
影响因子：
3.4
通讯作者：
R. Pecini;H. Elming;O. Pedersen;C. Torp-Pedersen
中科院分区：
文献类型：
--
作者：
R. Pecini;H. Elming;O. Pedersen;C. Torp-Pedersen
心房颤动是最常见的持续性心律失常，也是抗心律失常治疗的常见原因。现有的抗心律失常药物具有重要的副作用，目前维持窦性心律的治疗并不上级控制过度心率的策略。本文综述了目前改善房颤抗心律失常治疗的策略。最重要的策略是：i）开发没有促心律失常作用的药物-开发没有QT延长潜力的药物是主要策略; ii）多通道阻断药物-受胺碘酮疗效的启发，正在开发几种具有与胺碘酮相似的电生理特性但没有心外副作用的药物; iii）仅作用于心房的药物-心房含有特定的钾通道，并且仅作用于这些通道的几种药物正在开发中;和iv）对离子通道没有影响的抗肿瘤治疗-抑制肾素-血管紧张素系统和类固醇疗法已显示在治疗心房纤维性颤动中具有一定效果。许多药物正在开发中，治疗房颤的治疗方案可能会迅速改变。
Atrial fibrillation is the most common sustained cardiac arrhythmia and is a frequent reason for antiarrhythmic therapy. Existing antiarrhythmic drugs have important side effects and presently the therapy to maintain sinus rhythm is not superior to a strategy of controlling excessive heart rate. This review summarises current strategies to improve antiarrhythmic therapy for atrial fibrillation. The most important strategies are: i) to develop drugs without proarrhythmic effects – development of drugs devoid of QT prolonging potential is the main strategy; ii) multiple channel-blocking drugs – inspired by the efficacy of amiodarone, several drugs are being developed that have similar electrophysiological properties as amiodarone, but without the extracardiac side effects; iii) drugs that act exclusively in the atria – the atria contain specific potassium channels, and several drugs that act only on these channels are in development; and iv) antiarrhythmic therapy without effects on ion channels – inhibition of the renin–angiotensin system and steroid therapy has been shown to have some effect in the treatment of atrial fibrillation. Many drugs are in development and the therapeutic scenario for treatment of atrial fibrillation may change quickly.