Abstract
Atrial fibrillation (AF) is a highly prevalent arrhythmia and responsible for significant morbidity, mortality and health care cost. Considerable work has been performed to improve medical options but treatment success still remains suboptimal. The use of conventional anti-arrhythmic agents has been limited by potentially fatal ventricular proarrhythmia. Thus, novel drug targets have been characterised and are currently being tested in experimental and clinical studies. The atrially (but not ventricularly) expressed ion channel subunit Kv1.5 (conducting the ultra-rapid delayed rectifier, IKur) is a prominent candidate. A variety of drugs that inhibit this current is being evaluated. Human experience with these agents is limited. Atrial expression of connexin 40 and downregulation of this protein in AF turn its modulation into a potential therapeutic approach. The acetylcholine-activated current (IKACh) is another novel candidate target for drug therapy. The constitutively active form of this current is increased in human AF and pharmacological inhibition might be of therapeutic value. Certain drugs have IKACh blocking properties, but as for IKur-blockers none to date has shown pure selectivity for this current. This article summarizes relevant aspects of the cellular electrophysiology of AF and reviews the actions of pharmacological agents presently available or in development as novel anti-arrhythmic therapy.
Keywords: Atrial fibrillation, pharmacotherapy, HERG, proarrhythmia, ventricular fibrillation
Current Vascular Pharmacology
Title: Novel Anti-Arrhythmic Drugs for Atrial Fibrillation Management
Volume: 5 Issue: 3
Author(s): Joachim R. Ehrlich, Stanley Nattel and Stefan H. Hohnloser
Affiliation:
Keywords: Atrial fibrillation, pharmacotherapy, HERG, proarrhythmia, ventricular fibrillation
Abstract: Atrial fibrillation (AF) is a highly prevalent arrhythmia and responsible for significant morbidity, mortality and health care cost. Considerable work has been performed to improve medical options but treatment success still remains suboptimal. The use of conventional anti-arrhythmic agents has been limited by potentially fatal ventricular proarrhythmia. Thus, novel drug targets have been characterised and are currently being tested in experimental and clinical studies. The atrially (but not ventricularly) expressed ion channel subunit Kv1.5 (conducting the ultra-rapid delayed rectifier, IKur) is a prominent candidate. A variety of drugs that inhibit this current is being evaluated. Human experience with these agents is limited. Atrial expression of connexin 40 and downregulation of this protein in AF turn its modulation into a potential therapeutic approach. The acetylcholine-activated current (IKACh) is another novel candidate target for drug therapy. The constitutively active form of this current is increased in human AF and pharmacological inhibition might be of therapeutic value. Certain drugs have IKACh blocking properties, but as for IKur-blockers none to date has shown pure selectivity for this current. This article summarizes relevant aspects of the cellular electrophysiology of AF and reviews the actions of pharmacological agents presently available or in development as novel anti-arrhythmic therapy.
Export Options
About this article
Cite this article as:
Joachim R. Ehrlich , Stanley Nattel and Stefan H. Hohnloser , Novel Anti-Arrhythmic Drugs for Atrial Fibrillation Management, Current Vascular Pharmacology 2007; 5 (3) . https://dx.doi.org/10.2174/157016107781024073
DOI https://dx.doi.org/10.2174/157016107781024073 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Lipoprotein (a) Management: Lifestyle and Hormones
Current Medicinal Chemistry Relationship Between the Pharmacokinetics of Levosimendan and Its Effects on Cardiovascular System
Current Drug Metabolism Achieving Better Blood Pressure Control in High-Risk Patients with Type 2 Diabetes Using Combination Antihypertensive Therapy
Vascular Disease Prevention (Discontinued) Myricetin Induces Apoptosis in HepG2 Cells Through Akt/p70S6K/Bad Signaling and Mitochondrial Apoptotic Pathway
Anti-Cancer Agents in Medicinal Chemistry Crocetin Attenuates Spatial Learning Dysfunction and Hippocampal Injury in a Model of Vascular Dementia
Current Neurovascular Research Processed Foods, Dysbiosis, Systemic Inflammation, and Poor Health
Current Nutrition & Food Science Incretin-based Therapies for Type 2 Diabetes Mellitus: Effects on Insulin Resistance
Current Diabetes Reviews Neutrophil F-actin Dynamics in Familial Mediterranean Fever: The Unequal Effect of Colchicine on Activated Neutrophils
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Drug-Induced Hypokalaemia
Current Drug Safety Combination Therapy of Statins with Ezetimibe
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Electronic Noses in Medical Diagnostics
Current Medicinal Chemistry Is the Vascular System a Main Target for Thyroid Hormones? From Molecular and Biochemical Findings to Clinical Perspectives
Current Vascular Pharmacology Structural, Biochemical and Non-Traditional Cardiovascular Risk Markers in PCOS
Current Pharmaceutical Design Antioxidant, Anti-Inflammatory and Anticancer Activities of the Methanolic Extract of Thottea siliquosa: An <i>In Vitro</i> and <i>In Silico</i> Study
Recent Patents on Anti-Cancer Drug Discovery Treatment of Periodontitis for the Prevention of Endothelial Dysfunction: A Narrative Review
Current Vascular Pharmacology Type 2 Diabetes and Heart Failure: Challenges and Solutions
Current Cardiology Reviews Oxidative Stress in Diabetic Nephropathy
Current Medicinal Chemistry Intra-Renal Hemodynamic Changes After Habitual Physical Activity in Patients with Chronic Kidney Disease
Current Pharmaceutical Design Genetic and Environmental Influences on Therapeutic and Toxicity Outcomes: Studies with CYP2A6
Current Clinical Pharmacology Why is the Incidence of Type 1 Diabetes Increasing?
Current Diabetes Reviews