[Anti-arrhythmia drugs in geriatric patients]

Owing to the special pharmacodynamic and pharmacokinetic situation in the aged, the therapeutic spectrum of antiarrhythmic agents is very narrow. The indication for these substances must be established in accordance with strict criteria. Once indicated, antiarrhythmic drug therapy must be initiated at the lowest possible dose, and increases in dosage must be gradual. Non-controlled empirical treatment with such drugs rejected, and the success or lack of success of such treatment must be checked using suitable methods, for example, Holter monitoring. Since the patients often have multiple diseases, particular attention must be paid to interactions with other drugs. Careful consideration must be given to the possibility of Cardiac side effects of antiarrhythmic agents such as proarrhythmic or negative inotropic effects.