Антиаритмічні препарати – сучасне застосування та прийняття клінічних рішень

This review is devoted to the current use of antiarrhythmic drugs (AAD). Despite extensive research on AAD in recent years, there have been no significant improvements in the clinical pharmacology of arrhythmias. AAD are not neutral drugs due to serious cardiac and extracardiac side effects, as well as a narrow therapeutic profile and complex drug interactions. The main mechanisms of arrhythmias, aspects of their occurrence, maintenance and termination are considered. The current data on the mechanisms of cardiac arrhythmias are summarized, including circulation of excitation (or re-entry) and abnormalities of excitation generation (automatism), as well as ectopic excitations in the form of trigger activity. One of the key aspects of the new paradigm of antyarrhythmic therapy is the search for and action on “vulnerable” arrhythmia parameters. Information aboute remodeling of ion channel properties is presented. The presented classifications of AAD summarize current views on their electrophysiological actions, allow for the existence of multiple drug targets/actions, as well as side effects, which helps to understand and treat cardiac arrhythmias clinically.