Anti-Arrhythmia Agents ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Humans

Humans ; Anti-Arrhythmia Agents/therapeutic use* ; China ; Consensus

Anti-Arrhythmia Agents ; therapeutic use ; Arrhythmias, Cardiac ; drug therapy ; Child ; Humans ; Sotalol ; therapeutic use

Anti-Arrhythmia Agents ; adverse effects ; therapeutic use ; Arrhythmias, Cardiac ; drug therapy ; Humans

Rhythm control is crucial part of comprehensive management of atrial fibrillation (AF). Rhythm control can reduce the burden of AF effectively, reduce symptoms, and improve the prognosis in early AF. Antiarrhythmic drugs (AADs) are the first-line treatment for rhythm-control strategies. This consensus focuses on the principle of rhythm control in AF, the characteristics of AADs, and the medication recommendations for patients in different populations suffering from AF. Hence, this consensus aims to support clinical decision-making for AF therapy.
Humans ; Anti-Arrhythmia Agents/therapeutic use* ; Atrial Fibrillation/drug therapy* ; Consensus ; China

Humans ; Atrial Fibrillation/surgery* ; Anti-Arrhythmia Agents/therapeutic use* ; Treatment Outcome ; Catheter Ablation ; Recurrence

Humans ; COVID-19/complications* ; Arrhythmias, Cardiac/diagnosis* ; Anti-Arrhythmia Agents/therapeutic use*

The basic physiological function of anti-arrhythmic drugs is affects myocardial cell membrane ion channels. Change the ion flow and affect cell electrophysiological properties, change the conduction velocity, eliminate retrace, inhibit autorhythmicity and trigger events, inhibit the occurrence of arrhythmia, but will trigger a new activities, new retrace, produce new arrhythmia. In recent years, with the improvement of the theoretical system of traditional Chinese medicine and the production of new research methods, Chinese medicine treatment of arrhythmia has a new development. This article summarized the recent decades of which Chinese medicine monomer anti-arrhythmic drugs that had been proved by the influence of monomer anti-arrhythmic drugs, lists the differents traditional Chinese medicinal materials which chemical composition and the effective of the anti-arrhythmic effects, shows the unique advantages of Chinese medicine in the aspect of anti-arrhythmic, and points out that the current Chinese medicine in anti-arrhythmic (monomer) existing problems and solutions.
Anti-Arrhythmia Agents ; therapeutic use ; Arrhythmias, Cardiac ; drug therapy ; Biomedical Research ; Drugs, Chinese Herbal ; therapeutic use ; Humans

BACKGROUNDIbutilide has been commonly used for pharmacologic cardioversion of atrial fibrillation and flutter in clinical settings. The objective of this study was to investigate the effects of ibutilide on the defibrillation threshold (DFT), restitution properties, dispersion of refractoriness and activation patterns during ventricular fibrillation (VF).

METHODSIbutilide was administrated intravenously in six open-chest beagles. Before and after the drug administration, 20-second episodes of VF were electrically induced and recorded with a 10×10 unipolar electrode plaque sutured on the lateral epicardium of the left ventricle. DFT and VF activation patterns, including type of epicardial activation maps, VF cycle length (VF-CL), conduction velocity, wavelength (WL) and reentry incidence, were measured. Restitution properties and dispersion of refractoriness were estimated from activation recovery intervals (ARI) during pacing.

RESULTSCompared to baseline, ibutilide markedly decreased the DFT by 31% ((491 ± 14) V vs. (337 ± 59) V, P < 0.01). The drug significantly reduced the maximal slope of the restitution curve (1.34 ± 0.08 vs. 0.76 ± 0.06, P < 0.01) and its epicardial dispersion (0.36 ± 0.09 vs. 0.21 ± 0.06, coefficient of variation, P = 0.03). The dispersion of refractoriness was enhanced at the pacing cycle length of 300 ms to 160 ms by ibutilide. The drug significantly increased the VF-CL ((96 ± 19) ms vs. (112 ± 20) ms, P < 0.01) and the WL ((41 ± 9) mm vs. (52 ± 14) mm, P = 0.02) during VF, and reduced the reentry incidence by 25% (0.08 ± 0.02 vs. 0.06 ± 0.02, P < 0.01). In the epicardial activation maps, ibutilide significantly reduced the percentage of more complex activation maps during VF.

CONCLUSIONSIntravenous ibutilide significantly decreased the DFT. It might be due to reduction of activation pattern complexity during VF.

Animals ; Anti-Arrhythmia Agents ; therapeutic use ; Dogs ; Pericardium ; drug effects ; Sulfonamides ; therapeutic use ; Ventricular Fibrillation ; drug therapy ; physiopathology

BACKGROUND: Post hoc analysis of the landmark atrial fibrillation follow-up investigation of rhythm management trial revealed that amiodarone was associated with higher risks of mortality, intensive care unit admission, and non-cardiovascular death. We aim to evaluate the association between amiodarone use and patient survival under updated medical mode and level using data from the China Atrial Fibrillation (China-AF) Registry study. METHODS: Clinical data of 8161 non-valvular atrial fibrillation (NVAF) patients who were antiarrhythmic drug (AAD)-naive before enrollment into the China-AF Registry, recruited between August 2011 and February 2017, were collected. The primary outcome was all-cause mortality. A Cox proportional hazard regression model was used to evaluate the association between amiodarone use and the outcome. We also calculated the rate of sinus rhythm maintenance at the penultimate follow-up. RESULTS: Compared with 6167 patients of non-AAD group, 689 patients of the amiodarone group were younger (mean age 65.6 vs. 68.6 years), more frequently completed high school education, had fewer comorbidities such as chronic heart failure, prior bleeding, and stroke, and were more likely to be treated in tertiary hospitals while less hospitalization. The proportion of persistent AF was much lower among users of amiodarone, who were also less likely to be taking oral anticoagulants. The patients in the amiodarone group had a statistically insignificant lower incidence of all-cause mortality (2.44 vs. 3.91 per 100 person-years) over a mean follow-up duration of 300.6 ± 77.5 days. After adjusting for potential confounders, amiodarone use was not significantly associated with a lower risk of all-cause mortality (adjusted hazard ratio, 0.79; 95% confidence interval, 0.42-1.49). Sub-group analysis revealed the consistent results. The rate of sinus rhythm maintenance at the penultimate follow-up in the amiodarone group was significantly higher than in the non-AAD group. CONCLUSIONS Our study indicated that amiodarone use was not significantly associated with a lower risk of 1-year all-cause mortality compared with a non-AAD strategy in "real-world" patients with NVAF.
Aged ; Amiodarone/therapeutic use* ; Anti-Arrhythmia Agents/therapeutic use* ; Atrial Fibrillation/drug therapy* ; China ; Humans ; Prospective Studies ; Registries