Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

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

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

2.4K
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,...
2.4K
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

1.6K
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...
1.6K
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

963
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
963
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

1.2K
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...
1.2K
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

1.3K
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...
1.3K
Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

2.1K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
2.1K

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Low-dose digoxin in patients with heart failure with reduced or mildly reduced ejection fraction: a randomized controlled trial.

Nature medicine·2026
Same author

Risk prediction of atrial fibrillation progression in patients with paroxysmal atrial fibrillation: data from the RACE V study.

International journal of cardiology. Heart & vasculature·2026
Same author

Exploring the relationship between trauma- and stressor-related disorders and top-down central sensitization: A systematic review and meta-analysis.

Journal of psychosomatic research·2026
Same author

Polypharmacy and cardiovascular co-morbidity as key contributors to frailty in geriatric patients with AF - insights of the Dutch-GERAF cohort study.

BMC geriatrics·2026
Same author

Healthcare professionals' perspectives on prescribing DOACs to frail older patients; the DOAC-FRAIL questionnaire.

BMC geriatrics·2026
Same author

Predicting clinically relevant bleeding in new-onset atrial fibrillation patients initiating oral anticoagulant therapy: External validation of the AF-BLEED score.

Thrombosis research·2025

Related Experiment Video

Updated: Nov 30, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.7K

[Contraindications to DOACs in atrial fibrillation].

T A C de Vries1, M E W Hemels2, R Pisters3

  • 1Rijnstate, afd. Cardiologie, Arnhem(tevens: Amsterdam UMC, locatie AMC-UvA, afd. Cardiologie, Amsterdam).

Nederlands Tijdschrift Voor Geneeskunde
|November 17, 2020
PubMed
Summary

Anticoagulant therapy is recommended for elderly patients with atrial fibrillation, preferably using direct oral anticoagulants. Comprehensive risk assessment is advised for other high-risk subgroups before deciding on treatment.

More Related Videos

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

84.1K
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
08:42

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China

Published on: February 11, 2022

3.9K

Related Experiment Videos

Last Updated: Nov 30, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.7K
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

84.1K
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
08:42

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China

Published on: February 11, 2022

3.9K

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Atrial fibrillation patients often present with comorbidities increasing bleeding or clotting risks.
  • Uncertainty exists regarding anticoagulant use in frail elderly, those with organ impairment, or bleeding history.

Purpose of the Study:

  • To clarify anticoagulant indications in atrial fibrillation patients with specific risk factors.
  • To guide clinical decision-making for anticoagulant initiation in complex patient subgroups.

Main Methods:

  • Review of clinical data and guidelines regarding anticoagulant therapy in atrial fibrillation.
  • Analysis of risk-benefit profiles in elderly and comorbid patient populations.

Main Results:

  • Anticoagulants are indicated in 'vital elderly' atrial fibrillation patients, with direct oral anticoagulants preferred based on strong evidence.
  • Data for other high-risk groups (frailty, kidney/liver impairment, hypertension, bleeding history) may not fully translate to clinical practice.

Conclusions:

  • A thorough risk assessment and discussion of treatment pros and cons are essential for anticoagulation decisions in complex atrial fibrillation cases.
  • Non-use of anticoagulants is rarely justified, even in patients with increased bleeding risks.