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Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

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...

Depolarizing Blockers: Mechanism of Action

Depolarizing Blockers: Mechanism of Action

Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...

Cardiac Action Potential

Cardiac Action Potential

Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

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...

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

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...

Disturbances in Heart Rhythm

Disturbances in Heart Rhythm

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...

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Related Experiment Video

Updated: Jun 12, 2025

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

Ketamine Terminating Persistent Ventricular Tachycardia.

Rejina Fahhoum¹, Bilal Abaid¹, Zachary Ellis¹

¹Baptist Memorial Hospital North Mississippi, Oxford, Mississippi, USA.

JACC. Case Reports

|September 19, 2024

Summary

This summary is machine-generated.

Ventricular tachycardia (VT) storm, a severe heart rhythm issue, can be refractory to standard treatments. This case study shows ketamine successfully terminated a patient's VT storm, offering a new therapeutic option.

Keywords:

antiarrhythmic drugs ketamine refractory ventricular tachycardia ventricular tachycardia storm

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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

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Area of Science:

Cardiology
Pharmacology
Critical Care Medicine

Background:

Ventricular tachycardia (VT) is a serious heart arrhythmia linked to sudden cardiac death.
VT storm, characterized by recurrent VT episodes, necessitates prompt and aggressive antiarrhythmic interventions.
Refractory VT storm often requires advanced therapies like sedation, mechanical ventilation, or catheter ablation.

Observation:

A patient with ischemic cardiomyopathy presented with a refractory VT storm.
Standard antiarrhythmic treatments were ineffective in managing the recurrent VT episodes.

Findings:

Administration of ketamine resulted in the successful termination of the VT storm.
This suggests ketamine as a potential adjunctive therapy for refractory VT storm.

Implications:

Ketamine may represent a novel therapeutic strategy for managing life-threatening VT storm.
Further research is warranted to explore the efficacy and safety of ketamine in this clinical context.
This case broadens the therapeutic armamentarium for patients with refractory ventricular arrhythmias.