Is there a need for new antiarrhythmic drugs?

Currently available antiarrhythmic drugs were developed at a time when the basic mechanisms underlying most arrhythmias were conjectural at best. Indeed, the molecular targets upon which drugs act to prevent (or to exacerbate) arrhythmias are only now being defined. Thus, recent advances in the treatment of patients with arrhythmias have emphasized non-pharmacologic approaches, which use new information on the pathophysiology of specific arrhythmias to deliver targeted therapies. For some arrhythmias, such as atrial fibrillation, it seems likely that drug therapy will remain an important part of treatment. With increasing cellular and molecular understanding of the determinants of normal and abnormal cardiac electrogenesis, it should be possible to develop effective and safer drugs for the treatment of cardiac arrhythmias.