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Neue Antiarrhythmika in der Therapie des Vorhofflimmerns

II. Nicht-Ionenkanalblocker

New antiarrhythmic drugs for therapy of atrial fibrillation: II. Non-ion channel blockers

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Summary

The therapeutic approach to atrial fibrillation is difficult and challenging. The effect of “classical” antiarrhythmic agents is based on their inhibitory effects on various ion channels. However, therapeutic benefit of these agents is often limited. The primary goal of this article is to discuss new therapeutic approaches using non-ion channel blocking drugs in the treatment of atrial fibrillation. Some of the substances discussed in this article have been used already in the clinical practice. Others, for example gentherapeutic approaches, are still in the experimental state. In contrast to ion channel blocking agents their efficacy is based on the suppression of structural remodeling. Hence, it can be assumed that due to these effects they may also be beneficial in the primary prevention of atrial fibrillation.

Zusammenfassung

Die Behandlung des Vorhofflimmerns (VHF) ist schwierig und für den behandelnden Arzt eine Herausforderung. Die medikamentöse Therapie mit den „klassischen“ ionenkanalblockierenden Substanzen ist in der Effektivität limitiert und birgt insbesondere das Risiko der Proarrhythmie. Ziel dieses Artikels ist es, alternative Behandlungsstrategien mit „Nicht-Ionenkanalblockern“ aufzuzeigen, welche zum Teil schon Einzug in den klinischen Alltag gefunden haben und zum Teil, wie einige gentherapeutische Ansätze, noch im experimentellen Stadium sind. Anders als klassische Antiarrhythmika besteht ihr Wirkprinzip vor allem in der Beeinflussung des strukturellen Remodeling der Vorhöfe. Daher kommt ihnen auch eine Bedeutung im Rahmen der Primärprävention des VHF zu.

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Authors and Affiliations

  1. Otto-von-Guericke Universitätsklinik Magdeburg, Klinik für Kardiologie, Angiologie und Pneumologie, Leipzigerstr. 44, 39120, Magdeburg, Germany

    M. Hammwöhner, A. D’Alessandro &  A. Goette

  2. Technische Universität Dresden, Institut für Pharmakologie und Toxikologie, Medizinische Fakultät Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany

    D. Dobrev

  3. Universitätsklinikum Münster, Medizinische Klinik und Poliklinik C, Kardiologie und Angiologie, 48129, Münster, Germany

    P. Kirchhof

Authors
  1. M. Hammwöhner
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  2. A. D’Alessandro
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  3. D. Dobrev
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  4. P. Kirchhof
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  5. A. Goette
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Correspondence to A. Goette.

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Hammwöhner, M., D’Alessandro, A., Dobrev, D. et al. Neue Antiarrhythmika in der Therapie des Vorhofflimmerns. Herzschr. Elektrophys. 17, 73–80 (2006). https://doi.org/10.1007/s00399-006-0513-1

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  • DOI: https://doi.org/10.1007/s00399-006-0513-1

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