Antiarrhythmic drugs for atrial fibrillation: lessons from the past and opportunities for the future

Jordi Heijman*, Stefan H. Hohnloser, A. John Camm

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Web of Science)

Abstract

Atrial fibrillation (AF) remains a highly prevalent and troublesome cardiac arrhythmia, associated with substantial morbidity and mortality. Restoration and maintenance of sinus rhythm (rhythm-control therapy) is an important element of AF management in symptomatic patients. Despite significant advances and increasing importance of catheter ablation, antiarrhythmic drugs (AADs) remain a cornerstone of rhythm-control therapy. During the past 50years, experimental and clinical research has greatly increased our understanding of AADs. As part of the special issue on paradigm shifts in AF, this review summarizes important milestones in AAD research that have shaped their current role in AF management, including (i) awareness of the proarrhythmic potential of AADs; (ii) increasing understanding of the pleiotropic effects of AADs; (iii) the development of dronedarone; and (iv) the search for AF-specific AADs. Finally, we discuss short- and long-term opportunities for better AF management through advances in AAD therapy, including personalization of AAD therapy based on individual AF mechanisms.

Original languageEnglish
Pages (from-to)14-22
Number of pages9
JournalEP Europace
Volume23
DOIs
Publication statusPublished - Apr 2021

Keywords

  • Atrial fibrillation
  • Antiarrhythmic drugs
  • Dronedarone
  • Ion channels
  • RAPID CONVERSION
  • DRONEDARONE
  • THERAPY
  • CARDIOVERSION
  • RANOLAZINE
  • RHYTHM

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