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Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...

Dysrhythmias II: Classification of Tachyarrhythmias

Dysrhythmias II: Classification of Tachyarrhythmias

Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...

Dysrhythmias III: Characteristics of Dysrhythmias

Dysrhythmias III: Characteristics of Dysrhythmias

Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per minute.

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...

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Related Experiment Video

Updated: Jul 13, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

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Published on: December 28, 2012

QT interval prolongation and torsade de pointes.

Salvatore Patanè, Filippo Marte, Gianluca Di Bella

International Journal of Cardiology

|August 11, 2007

Summary

Torsade de pointes, a dangerous heart rhythm, can be caused by certain medications. This case highlights the risk in a patient taking multiple drugs, including sotalol and sertraline.

Area of Science:

Cardiology
Clinical Pharmacology

Background:

Torsade de pointes (TdP) is a specific type of polymorphic ventricular tachycardia.
It is characterized by a prolonged QT interval on an electrocardiogram.
Drug-induced QT prolongation is a known risk factor for TdP.

Observation:

A 72-year-old Italian woman developed TdP.
The patient was undergoing treatment with multiple medications: sotalol, sertraline, digoxin, and acenocumarine.

Findings:

The case suggests a potential link between the combination of sotalol, sertraline, digoxin, and acenocumarine and the development of TdP.
This highlights the complex interplay of pharmacotherapy in cardiac repolarization.

Implications:

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Clinicians should be vigilant for TdP in patients on polypharmacy, especially with drugs known to affect QT interval.

Careful medication review and monitoring are crucial to prevent adverse cardiac events.