Update on antiarrhythmic drugs in emergency medicine

Most patients presenting to the Emergency Department with acute arrhythmias can be adequately treated with the available, conventional antiarrhythmics. Recent studies have taught us to use them with better understanding. In the future, several new antiarrhythmics look promising for use in the Emergency Department when given by the intravenous route; particularly, pirmenol, encainide, esmolol, amiodarone, sotalol, and magnesium. However, there have been few comparison studies between various antiarrhythmics, and experience must be gained for a full understanding of the benefits and risks of these agents.