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Clinical Use of Class Ia Antiarrhythmic Drugs

  • Chapter
Antiarrhythmic Drugs

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 89))

Abstract

Quinidine is by far the oldest agent developed solely as an antiarrhythmic drug. It is an isomer of quinine, derived from cinchona bark, which was reported as being useful for palpitations (presumably atrial fibrillation) in 1749 (Willius and Keys 1942). The regular prescription of quinidine for atrial fibrillation dates largely from the work of Wenckebach, Frey, Lewis and Love, between 1914 and 1926 (Vaughan Williams 1980). Quinidine was also the first drug recognized effective against ventricular tachycardia (Selzer 1982), and despite the large number of alternative agents now available, it is still one of the most popular antiarrhythmic drugs in many countries, including the United States. Mautz (1936) first demonstrated antiarrhythmic properties for procaine. This compound is, however, too rapidly hydrolyzed to be of clinical use. A study of related substances led to the introduction of procainamide (Mark et al. 1951). It remains an extremely widely prescribed antiarrhythmic drug particulary in the management of ventricular arrhythmias. Its efficacy in supraventricular arrhythmias has also been amply demonstrated (Woske et al. 1953; Fenster et al. 1983). Disopyramide is an example of a deliberate search for an antiarrhythmic agent as an alternative to quinidine and procainamide. It was found to have significant efficacy against arrhythmias in animals (Mokler and van Arman 1962) and man (Katz et al. 1963).

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Campbell, T.J. (1989). Clinical Use of Class Ia Antiarrhythmic Drugs. In: Vaughan Williams, E.M. (eds) Antiarrhythmic Drugs. Handbook of Experimental Pharmacology, vol 89. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-73666-7_9

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