Premium
Atrial‐selective sodium channel block as a novel strategy for the management of atrial fibrillation
Author(s) -
Antzelevitch Charles,
Burashnikov Alexander
Publication year - 2010
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2009.05086.x
Subject(s) - ranolazine , atrial fibrillation , medicine , cardiology , amiodarone , management of atrial fibrillation , sodium channel blocker , sodium channel , pharmacology , sodium , chemistry , organic chemistry
Safe and effective pharmacologic management of atrial fibrillation (AF) is one of the greatest challenges facing an aging society. Currently available pharmacologic strategies for rhythm control of AF are associated with ventricular arrhythmias and in some cases multi‐organ toxicity. Consequently, drug development has focused on atrial‐selective agents such as I Kur blockers. Recent studies suggest that I Kur block alone may be ineffective for suppression of AF and may promote AF in healthy hearts. Recent experimental studies have demonstrated other important electrophysiologic differences between atrial and ventricular cells, particularly with respect to sodium channel function, and have identified sodium channel blockers that exploit these electrophysiologic distinctions. Atrial‐selective sodium channel blockers, such as ranolazine and amiodarone, effectively suppress and/or prevent the induction of AF in experimental models, while producing little to no effect on ventricular myocardium. These findings suggest that atrial‐selective sodium channel block may be a fruitful new strategy for the management of AF.