Elming Hanne, Brendorp Bente, Pehrson Steen, Pedersen Ole Dyg, Køber Lars, Torp-Petersen Christian
Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Expert Opin Drug Saf. 2004 Nov;3(6):559-77. doi: 10.1517/14740338.3.6.559.
The prevalence of arrhythmia in the population is increasing as more people survive for longer with cardiovascular disease. It was once thought that antiarrhythmic therapy could save life, however, it is now evident that antiarrhythmic therapy should be administrated with the purpose of symptomatic relief. Since many patients experience a decrease in physical performance as well as a diminished quality of life during arrhythmia there is still a need for antiarrhythmic drug therapy. The development of new antiarrhythmic agents has changed the focus from class I to class III agents since it became evident that with class I drug therapy the prevalence of mortality is considerably higher. This review focuses on the benefits and risks of known and newer class III antiarrhythmic agents. The benefits discussed include the ability to maintain sinus rhythm in persistent atrial fibrillation patients, and reducing the need for implantable cardioverter defibrillator shock/antitachycardia therapy, since no class III antiarrhythmic agents have proven survival benefit. The risks discussed mainly focus on pro-arrhythmia as torsade de pointes ventricular tachycardia.
随着越来越多的心血管疾病患者存活时间延长，人群中心律失常的患病率正在上升。曾经人们认为抗心律失常治疗可以挽救生命，然而，现在很明显抗心律失常治疗应以缓解症状为目的。由于许多患者在心律失常期间身体机能下降且生活质量降低，因此仍然需要抗心律失常药物治疗。自从有证据表明I类药物治疗的死亡率相当高以来，新型抗心律失常药物的开发已将重点从I类药物转向III类药物。本综述重点关注已知和新型III类抗心律失常药物的益处和风险。所讨论的益处包括能够使持续性房颤患者维持窦性心律，以及减少植入式心脏复律除颤器电击/抗心动过速治疗的需求，因为尚无III类抗心律失常药物被证明具有生存益处。所讨论的风险主要集中在致心律失常作用，如尖端扭转型室性心动过速。
