[The principles of pharmacotherapy for arrhythmia at the turn of the millenium]

A review is presented at the main causes of the change in paradigm that has occurred in the past 10 years in antiarrhythmic pharmacotherapy. The new attitude is ascribed to (1) the advances made in the application of non-pharmacological therapeutic modalities (radiofrequency catheter ablation, implantable antiarrhythmic devices), (2) the modification of therapeutic practice in response to the results of large-scale prospective randomized clinical trials, and (3) the proper recognition and appropriate appreciation of the frequently life-threatening proarrhythmic action of antiarrhythmic drugs. The current state of knowledge is discussed as concerns the anti- and proarrhythmic effects of the drugs available at present, and also their safe clinical use.