[The trend of anti-arrhythmic drug development]

New anti-arrhythmic drugs have been developed by the progress of molecular-biological and physiological research on an ion channel and the elucidation of pharmacological effects of traditional anti-arrhythmic drugs. After CAST study, K+ channel blockers instead of Na+ channel blockers were developed and used in anti-arrhythmic treatment. In Sicilian Gambit, it was advocated that the anti-arrhythmic drug selection was based on both pharmacological action of drugs and mechanism of arrhythmias, including electrical remodeling which was mainly studied on atrial fibrillation and structural remodeling such as myocardial fibrosis. Furthermore, the target of anti-arrhythmic treatment will be not only the arrhythmic control with drugs but changing many factors related to the arrhythmic substrates, modulators and triggers of arrhythmias.