A benefit-risk assessment of class III antiarrhythmic agents

TY - JOUR

T1 - A benefit-risk assessment of class III antiarrhythmic agents

AU - Elming, Hanne

AU - Brendorp, Bente

AU - Pehrson, Steen

AU - Pedersen, Ole Dyg

AU - Køber, Lars

AU - Torp-Pedersen, Christian Tobias

N1 - Keywords: Amiodarone; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Clinical Trials as Topic; Combined Modality Therapy; Defibrillators, Implantable; Heart Conduction System; Humans; Imidazolidines; Ion Transport; Life Tables; Membrane Potentials; Meta-Analysis as Topic; Phenethylamines; Piperazines; Risk Assessment; Sotalol; Sulfonamides; Survival Analysis; Torsades de Pointes; Treatment Outcome

PY - 2004

Y1 - 2004

N2 - The prevalence of arrhythmia in the population is increasing as more people survive for longer with cardiovascular disease. It was once thought that antiarrhythmic therapy could save life, however, it is now evident that antiarrhythmic therapy should be administrated with the purpose of symptomatic relief. Since many patients experience a decrease in physical performance as well as a diminished quality of life during arrhythmia there is still a need for antiarrhythmic drug therapy. The development of new antiarrhythmic agents has changed the focus from class I to class III agents since it became evident that with class I drug therapy the prevalence of mortality is considerably higher. This review focuses on the benefits and risks of known and newer class III antiarrhythmic agents. The benefits discussed include the ability to maintain sinus rhythm in persistent atrial fibrillation patients, and reducing the need for implantable cardioverter defibrillator shock/antitachycardia therapy, since no class III antiarrhythmic agents have proven survival benefit. The risks discussed mainly focus on pro-arrhythmia as torsade de pointes ventricular tachycardia.

AB - The prevalence of arrhythmia in the population is increasing as more people survive for longer with cardiovascular disease. It was once thought that antiarrhythmic therapy could save life, however, it is now evident that antiarrhythmic therapy should be administrated with the purpose of symptomatic relief. Since many patients experience a decrease in physical performance as well as a diminished quality of life during arrhythmia there is still a need for antiarrhythmic drug therapy. The development of new antiarrhythmic agents has changed the focus from class I to class III agents since it became evident that with class I drug therapy the prevalence of mortality is considerably higher. This review focuses on the benefits and risks of known and newer class III antiarrhythmic agents. The benefits discussed include the ability to maintain sinus rhythm in persistent atrial fibrillation patients, and reducing the need for implantable cardioverter defibrillator shock/antitachycardia therapy, since no class III antiarrhythmic agents have proven survival benefit. The risks discussed mainly focus on pro-arrhythmia as torsade de pointes ventricular tachycardia.

M3 - Journal article

C2 - 15500415

SN - 1474-0338

VL - 3

SP - 559

EP - 577

JO - Expert Opinion on Drug Safety

JF - Expert Opinion on Drug Safety

IS - 6

ER -