Management and prevention of tachyarrhythmias, especially of serious ventricular arrhythmias after myocardial infarction, is still a major problem. Large-scale evidence suggests an increased harm induced by antiarrhythmic drugs in the presence of organic heart disease although they effectively suppress spontaneous arrhythmias. This increased risk has been linked to their proarrhythmic potential and to possible interactions by ischaemia. However, the mechanisms by which antiarrhythmic drugs exert their antiarrhythmic and proarrhythmic actions are still poorly understood. Therefore, it was a time to present an update on the mechanisms of antiarrhythmic and proarrhythmic action of drugs which act on the electrophysiological properties of the heart. World renowned electrophysiologists as well as clinicians have joint to address important topics which range from the effect of antiarrhythmic drugs on single channels and on arrhythmia models to the clinical arena.
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