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Related Concept Videos

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

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Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
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Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

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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...
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Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

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Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
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Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

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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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Cardiovascular Drugs: Classification based on Therapeutic Indications01:18

Cardiovascular Drugs: Classification based on Therapeutic Indications

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Cardiovascular diseases, encompassing a range of conditions, can significantly affect the heart's operations and the overall circulatory system. These conditions impair the heart's ability to pump blood, leading to a deficit in oxygen supply to crucial organs. Anomalies in the heart's electrical system, known as arrhythmias, can cause heartbeats to accelerate or slow down. Usually, heart rates increase during physical activity and decrease while resting or sleeping. However,...
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Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

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Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
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Updated: Dec 22, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Low-dose Amiodarone Is Safe: A Systematic Review and Meta-analysis.

Ronpichai Chokesuwattanaskul1,2, Nupur Shah3, Susama Chokesuwattanaskul4

  • 1Sparrow Hospital, Michigan State University, Lansing, MI, USA.

The Journal of Innovations in Cardiac Rhythm Management
|May 6, 2020
PubMed
Summary
This summary is machine-generated.

Low-dose amiodarone (≤200 mg/day) has a 17% incidence of side effects, with 6% requiring discontinuation. Very-low-dose amiodarone (≤100 mg/day) shows significantly fewer adverse events, with only 2% leading to discontinuation.

Keywords:
Amiodaronelow dosemeta-analysissafetyside effect

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Amiodarone is a widely used antiarrhythmic drug (AAD) for various arrhythmias.
  • Its use is limited by dose- and duration-dependent side effects.
  • Low-dose amiodarone regimens are increasingly considered to mitigate risks.

Purpose of the Study:

  • To determine the incidence of side effects leading to discontinuation of low-dose (≤200 mg/day) and very-low-dose (≤100 mg/day) amiodarone.
  • To compare the safety profiles of these low-dose amiodarone regimens.

Main Methods:

  • A systematic literature search was conducted through June 2019.
  • Included studies reported amiodarone side effect incidence or prevalence.
  • Data from 10 observational cohort studies (901 patients) were meta-analyzed using random-effects modeling.

Main Results:

  • The pooled incidence of overall side effects for low-dose amiodarone (≤200 mg/day) was 17% (95% CI: 12-22%).
  • Side effects requiring discontinuation occurred in 6% (95% CI: 3-11%) of patients on low-dose amiodarone.
  • For very-low-dose amiodarone (≤100 mg/day), overall side effects were 11% (95% CI: 4-27%), with only 2% (95% CI: 1-6%) requiring discontinuation.

Conclusions:

  • Very-low-dose amiodarone (≤100 mg/day) demonstrates a low incidence of significant side effects.
  • The rate of amiodarone discontinuation due to adverse events is substantially reduced with very-low-dose regimens.
  • These findings support the use of very-low-dose amiodarone for managing arrhythmias when safety is a primary concern.