Adverse Effects of Antiarrhythmic Drugs

• Most of the antiarrhythmic drugs are associated with severe and sometimes life-threatening adverse effects.

• A number of recent clinical trials (such as CAST) have demonstrated that many antiarrhythmic drugs increase mortality relative to placebo treatment

• The adverse effects of antiarrhythmic drugs can be categorized according to cardiac effects and extra-cardiac effects:

  • Adverse cardiac effects:

    • - Adverse cardiac effects are often predictable based on antiarrhythmic class

    • - The most common and serious of adverse cardiac effects are proarrhythmias (a new or worsened rhythmic disturbance paradoxically precipitated by antiarrhythmic therapy) which can occur in 5-20% of patients treated with Class I and Class III drugs

  • Adverse extra-cardiac effects:

    • - Severe extra-cardiac effects are also common with the antiarrhythmics and tend to be drug-specific.

Category: Pharmacology Notes