Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Show Summary Details
Page of

Anti-arrhythmic drug therapy 

Anti-arrhythmic drug therapy
Chapter:
Anti-arrhythmic drug therapy
Author(s):

Dr Boon Lim

and Dr Pier Lambiase

DOI:
10.1093/med/9780199594764.003.0011
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2020. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 30 October 2020

The definition of a ‘landmark paper’ is multi-factorial as a paper can only be measured ultimately by its impact on clinical practice, whether positively, that is, by demonstrating the application of a specific therapy which has a significant and sustained clinical effect, or negatively, by informing the physician that therapy is not efficacious, or even dangerous. The technical criteria for such a publication should include the fact that the trial of therapy was randomized and double-blinded to avoid bias and the end points assessed should be unequivocal. The population recruited into the trial should reflect the target population treated by the physician such that it is relevant to contemporary practice. Therefore, any evaluation of landmark clinical trials of anti-arrhythmic drug therapy should begin with high quality randomized placebo controlled trials in large populations looking at key unequivocal primary end points which impact both on the individual patient and the management of populations in terms of mortality and cost-efficacy. In the anti-arrhythmic therapy field there are numerous small studies which demonstrate efficacy, but frequently the groups studied are too small to allow application to the wider population. The effects of these agents are often not pure or achieved through a single target. Figure 11.1 summarizes the main anti-arrhythmic classes, modulators of arrhythmia, and key therapeutic targets based upon arrhythmia mechanisms.

In this series of ten papers we have aimed to highlight the studies that have significantly changed or informed practice with the highest level of evidence. The series can be divided into trials of agents to prevent lethal arrhythmia and sudden death, atrial anti-arrhythmic agents (reflecting the high burden of atrial fibrillation (AF) in the community), and those trials which were important negatives, showing the detrimental effects of certain agents in specific patient populations.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.