Comparative evaluation of antiarrhythmic agents

The clinical drug armamentarium has been markedly expanded in recent years providing the physician with an increasing choice of antiarrhythmic agents to treat the needs of particular patients. Individually guided therapy is still the hallmark in the use of antiarrhythmic drugs, particularly with the wide variability of efficacy and toxicity and differing mechanisms of pharmacoelectrophysiological actions. The newest of the class I antiarrhythmic agents, the so-called: 'cainides' (Ic) appear to be particularly useful in testing the hypothesis that stabilisation of electrical instability may be an important goal if the high rate of sudden cardiac death is to be prevented. From the new tools available to the investigator (electrophysiological and Holter models, and many new antiarrhythmic agents), new approaches to the prevention of sudden death will emerge (Horowitz and Morganroth, 1982).