This chapter focuses on the electrophysiologic principles of antiarrhythmic drug treatment of supraventricular and ventricular arrhythmias in critically ill patients. Here we do not present a comprehensive review of individual antiarrhythmic agents but instead provide a framework for clinical approaches to antiarrhythmic drug selection based on the mechanisms of the target arrhythmia. Antiarrhythmic drugs are agents that exert their effects either directly or indirectly on cellular impulse generation or conduction. They alter cellular membrane potential by interactions with membrane receptors or ionic channels. This chapter presents an overview of antiarrhythmic drug management, including (1) a review of cellular electrophysiology, (2) a general classification of antiarrhythmic drugs, (3) a survey of arrhythmia mechanisms, and (4) clinical correlation of antiarrhythmic drug effects on the heart.
KeywordsAntiarrhythmic Drug Refractory Period Action Potential Duration Structural Heart Disease Plasma Drug Level
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