Antiarrhythmic Treatment in Atrial Fibrillation

Seema Ledan, PharmD


US Pharmacist. 2020;45(2):24-27. 

In This Article

Antiarrhythmic Agents

Selection of antiarrhythmic drugs should be based on underlying heart disease and comorbidities, and therapy should be guided first by safety and then by efficacy.[1]

Many of these agents affect ion channels and adrenergic receptors, causing a range of cardiac and noncardiac side effects.[10] However, antiarrhythmic agents may reduce frequency and duration of AF and improve the quality of life.[1] Table 1 provides an overview of the typical dosing of antiarrhythmic agents used for the maintenance of sinus rhythm in AF. Important factors to consider when selecting an antiarrhythmic agent (Table 2) include whether patients have coronary artery disease, heart failure, left ventricular hypertrophy, risk of bradyarrhythmias or excessive QT prolongation, history of torsades de pointes, and influences on drug disposition, such s age, renal/hepatic dysfunction, and drug interactions (Table 3).[1,10]