Kowey P R, Marinchak R A, Rials S J, Bharucha D
Division of Cardiovascular Diseases, Lankenau Hospital and Medical Research Center, Wynnewood, Pennsylvania 19096, USA.
Am J Cardiol. 1997 Oct 23;80(8A):16G-23G. doi: 10.1016/s0002-9149(97)00710-8.
Cardiac arrhythmias frequently respond only to drugs that have as their predominant electrophysiologic effect the prolongation of repolarization and refractoriness. According to the Singh-Vaughan Williams classification, these drugs are known as class III agents. In the last few years, interest has increased in the development of class III antiarrhythmic drugs as alternatives to sodium channel blocking agents, which mainly affect cardiac conduction. Much of this interest results from a perceived danger of using drugs with sodium channel blocking properties, particularly in patients with ischemic heart disease, based on the results of the Cardiac Arrhythmia Suppression Trial (CAST) and several other trials. This article is a review of the pharmacology, including the pharmacokinetics and pharmacodynamics, of the most commonly used and investigated class III antiarrhythmic drugs. As will be seen from the discussion, each of these drugs has novel pharmacology that makes it applicable in specific clinical situations. Their putative effects on various arrhythmogenic mechanisms and their efficacy in treating specific target arrhythmias will be addressed.
心律失常常常仅对那些以延长复极化和不应期作为主要电生理效应的药物有反应。根据辛格 - 沃恩·威廉姆斯分类法，这些药物被称为Ⅲ类药物。在过去几年中，作为主要影响心脏传导的钠通道阻滞剂的替代药物，Ⅲ类抗心律失常药物的研发受到了更多关注。这种关注很大程度上源于基于心律失常抑制试验（CAST）及其他一些试验的结果，人们察觉到使用具有钠通道阻滞特性的药物存在风险，尤其是在缺血性心脏病患者中。本文是对最常用且被研究的Ⅲ类抗心律失常药物的药理学（包括药代动力学和药效学）的综述。从讨论中可以看出，这些药物中的每一种都有独特的药理学特性，使其适用于特定的临床情况。将探讨它们对各种致心律失常机制的假定作用及其在治疗特定目标心律失常方面的疗效。
