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Antiarrhythmic Properties of Non-Antiarrhythmic Drugs in Atrial Fibrillation: Upstream Therapy

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Antiarrhythmic Drugs

Part of the book series: Current Cardiovascular Therapy ((CCT))

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Abstract

Traditionally, antiarrhythmic strategies have focused almost exclusively on atrial electrophysiological alterations. Unfortunately, these interventions yield very limited success over the long-term and have a high side-effect profile. A number of ‘non-antiarrhythmic’ drugs (i.e., whose main effect is not exerted at ion channel level) have gained increasing attention due to their potential to prevent, delay, or even reverse atrial fibrillation (AF)-related atrial structural remodeling, while lacking the undesirable effects of ion channel blockers. By modifying the substrate upstream of AF, these new strategies are expected to prevent new-onset AF, to delay AF transition to more persistent forms, and/or to prevent recurrent AF. However, to date, with very few the exceptions, there is insufficient evidence to support the wide use of non-conventional antiarrhythmic drugs for AF prophylaxis in clinical practice. It still remains to be established whether this approach is truly effective, by itself or at least in addition to conventional rhythm control strategies. Clarification of the most adequate target population, of the most suitable drug, dose, and timing to intervene is also required.

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Authors and Affiliations

  1. University of Medicine, Pharmacy, Science and Technology “George Emil Palade” of Târgu Mureş, Târgu Mureş, Romania

    Alina Scridon

  2. Department of Cardiology, University Hospital of Sabadell, Institut d’Investigació i Innovació I3PT, University Autonoma of Barcelona, Sabadell, Spain

    Antoni Martínez-Rubio

Authors
  1. Alina Scridon
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  2. Antoni Martínez-Rubio
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Editors and Affiliations

  1. Department of Cardiology, University Hospital of Sabadell, Institut d’Investigació i Innovació I3PT, University Autonoma of Barcelona, Sabadell, Spain

    Antoni Martínez-Rubio

  2. Department of Pharmacology, School of Medicine, Universidad Complutense, CIBERCV, Madrid, Spain

    Juan Tamargo

  3. “Carol Davila” University of Medicine, Colentina University Hospital, Bucharest, Romania

    Gheorghe- Andrei Dan

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Scridon, A., Martínez-Rubio, A. (2020). Antiarrhythmic Properties of Non-Antiarrhythmic Drugs in Atrial Fibrillation: Upstream Therapy. In: Martínez-Rubio, A., Tamargo, J., Dan, G . (eds) Antiarrhythmic Drugs. Current Cardiovascular Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-34893-9_7

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