Circulation, Vol 82, 2235-2242, Copyright © 1990 by American Heart Association
TJ Colatsky, CH Follmer and CF Starmer
Although work on class III antiarrhythmics remains at an early stage, these
agents still appear to possess greater efficacy and less proarrhythmia than
conventional class I agents in those experimental arrhythmia models
considered to be most representative of the clinical situation. Although
prolongation of repolarization carries with its own tendency for
pause-dependent arrhythmogenesis (i.e., torsade de pointes), available data
suggest that this may be a function of nonspecificity in potassium channel
block rather than a general characteristic of class III activity. The
availability of new and more selective blockers of specific cardiac
potassium channels under development as class III agents have already
helped to clarify basic questions about the ionic mechanism of
repolarization in the heart, and one hopes that a growing clinical data
base will eventually determine the relative safety and efficacy of these
agents in preventing symptomatic and life-threatening arrhythmias.
ARTICLES
Channel specificity in antiarrhythmic drug action. Mechanism of potassium channel block and its role in suppressing and aggravating cardiac arrhythmias
Division of Experimental Therapeutics, Wyeth-Ayerst Research, Princeton, New Jersey 08543.
This article has been cited by other articles:
 |
|
 |
|
  S. M. Schumacher, D. P. McEwen, L. Zhang, K. L. Arendt, K. M. Van Genderen, and J. R. Martens Antiarrhythmic Drug-Induced Internalization of the Atrial-Specific K+ Channel Kv1.5 Circ. Res., June 19, 2009; 104(12): 1390 - 1398. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. H. Choi, J.-A. Park, K.-R. Kim, G.-I. Lee, Y.-T. Lee, H. Choe, S.-H. Ko, M.-H. Kim, Y.-H. Seo, and Y.-G. Kwak Direct block of cloned hKv1.5 channel by cytochalasins, actin-disrupting agents Am J Physiol Cell Physiol, August 1, 2005; 289(2): C425 - C436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Choe, Y.-K. Lee, Y.-T. Lee, H. Choe, S.-H. Ko, C.-U. Joo, M.-H. Kim, G.-S. Kim, J.-S. Eun, J.-H. Kim, et al. Papaverine Blocks hKv1.5 Channel Current and Human Atrial Ultrarapid Delayed Rectifier K+ Currents J. Pharmacol. Exp. Ther., February 1, 2003; 304(2): 706 - 712. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. D Pitt, C. Fernandes, N. L Bewick, P. D Hemsworth, K. A Buhagiar, P. S Hansen, H. H Rasmussen, L. Delbridge, and D. W Whalley Chronic amiodarone-induced inhibition of the Na+-K+ pump in rabbit cardiac myocytes is thyroid-dependent: comparison with dronedarone Cardiovasc Res, January 1, 2003; 57(1): 101 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A Li, J. Miake, U. C Hoppe, D. C Johns, E. Marban, and H B. Nuss Functional consequences of the arrhythmogenic G306R KvLQT1 K+ channel mutant probed by viral gene transfer in cardiomyocytes J. Physiol., May 15, 2001; 533(1): 127 - 133. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. N. Singh and J. S. M. Sarma Mechanisms of Action of Antiarrhythmic Drugs Relative to the Origin and Perpetuation of Cardiac Arrhythmias Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2001; 6(1): 69 - 87. [PDF]
|
|
|
|
|
|
C. A Karle, V. A.W Kreye, D. Thomas, K. Rockl, S. Kathofer, W. Zhang, and J. Kiehn Antiarrhythmic drug carvedilol inhibits HERG potassium channels Cardiovasc Res, February 1, 2001; 49(2): 361 - 370. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. Kass and C. Cabo Channel structure and drug-induced cardiac arrhythmias PNAS, October 24, 2000; 97(22): 11683 - 11684. [Full Text] [PDF]
|
|
|
|
|
|
M. Weerapura, S. Nattel, M. Courtemanche, D. Doern, N. Ethier, and T. E Hebert State-dependent barium block of wild-type and inactivation-deficient HERG channels in Xenopus oocytes J. Physiol., July 15, 2000; 526(2): 265 - 278. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. K. Doshi and B. N. Singh Reviews: Pure Class III Antiarrhythmic Drugs: Focus on Dofetilide Journal of Cardiovascular Pharmacology and Therapeutics, January 1, 2000; 5(4): 237 - 247. [PDF]
|
|
|
|
 |
|
 C. W. Hogue Jr and M. L. Hyder Atrial fibrillation after cardiac operation: risks, mechanisms, and treatment Ann. Thorac. Surg., January 1, 2000; 69(1): 300 - 306. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Dorian and D. Newman Rate dependence of the effect of antiarrhythmic drugs delaying cardiac repolarization: an overview Europace, January 1, 2000; 2(4): 277 - 285. [Abstract] [PDF]
|
|
|
|
|
|
R. F. Bosch, G.-R. Li, R. Gaspo, and S. Nattel Electrophysiologic Effects of Chronic Amiodarone Therapy and Hypothyroidism, Alone and in Combination, on Guinea Pig Ventricular Myocytes J. Pharmacol. Exp. Ther., April 1, 1999; 289(1): 156 - 165. [Abstract] [Full Text]
|
|
|
|
|
|
M.-H. Wu, M.-J. Su, and S.S.M. Sun Electrophysiological profile after inward rectifier K channel blockade by barium in isolated rabbit hearts. Altered repolarization and unmasked decremental conduction property Europace, January 1, 1999; 1(2): 85 - 95. [Abstract] [PDF]
|
|
|
|
|
|
N. I. Nenov, W. J. Crumb Jr, J. D. Pigott, L. H. Harrison Jr, and C. W. Clarkson Quinidine Interactions With Human Atrial Potassium Channels : Developmental Aspects Circ. Res., December 14, 1998; 83(12): 1224 - 1231. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W.-C. Yu, S.-A. Chen, S.-H. Lee, C.-T. Tai, A.-N. Feng, B. I.-T. Kuo, Y.-A. Ding, and M.-S. Chang Tachycardia-Induced Change of Atrial Refractory Period in Humans : Rate Dependency and Effects of Antiarrhythmic Drugs Circulation, June 16, 1998; 97(23): 2331 - 2337. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M A Vos, S R Golitsyn, K Stangl, M Y Ruda, L Van Wijk, J D Harry, K T Perry, P Touboul, G Steinbeck, and H J J Wellens Superiority of ibutilide (a new class III agent) over DL-sotalol in converting atrial flutter and atrial fibrillation Heart, June 1, 1998; 79(6): 568 - 575. [Abstract] [Full Text]
|
|
|
|
|
|
L. Sen, G. Cui, Y. Sakaguchi, and B. N. Singh Electrophysiological Effects of MS-551, a New Class III Agent: Comparison with dl-Sotalol in Dogs J. Pharmacol. Exp. Ther., May 1, 1998; 285(2): 687 - 694. [Abstract] [Full Text]
|
|
|
|
 |
|
 A. A. Grace and A. J. Camm Quinidine N. Engl. J. Med., January 1, 1998; 338(1): 35 - 45. [Full Text] [PDF]
|
|
|
|
|
|
C. Fiset, B. Drolet, B. A. Hamelin, and J. Turgeon Block of IKs by the Diuretic Agent Indapamide Modulates Cardiac Electrophysiological Effects of the Class III Antiarrhythmic Drug dl-Sotalol J. Pharmacol. Exp. Ther., October 1, 1997; 283(1): 148 - 156. [Abstract] [Full Text]
|
|
|
|
|
|
I. Kodama, K. Kamiya, and J. Toyama Cellular electropharmacology of amiodarone Cardiovasc Res, July 1, 1997; 35(1): 13 - 29. [Full Text] [PDF]
|
|
|
|
|
|
W.-P. Yang, P. C. Levesque, W. A. Little, M. L. Conder, F. Y. Shalaby, and M. A. Blanar KvLQT1, a voltage-gated potassium channel responsible for human cardiac arrhythmias PNAS, April 15, 1997; 94(8): 4017 - 4021. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Feng, Z. Wang, G.-R. Li, and S. Nattel Effects of Class III Antiarrhythmic Drugs on Transient Outward and Ultra-rapid Delayed Rectifier Currents in Human Atrial Myocytes J. Pharmacol. Exp. Ther., April 1, 1997; 281(1): 384 - 392. [Abstract] [Full Text]
|
|
|
|
|
|
B. N. Singh Searching for the Ideal Class III Antiarrhythmic Agent: How Pure Should They Be? Journal of Cardiovascular Pharmacology and Therapeutics, January 1, 1997; 2(4): 239 - 242. [PDF]
|
|
|
|
|
|
D. M. Roden, R. Lazzara, M. Rosen, P. J. Schwartz, J. Towbin, and G. M. Vincent Multiple Mechanisms in the Long-QT Syndrome: Current Knowledge, Gaps, and Future Directions Circulation, October 15, 1996; 94(8): 1996 - 2012. [Abstract] [Full Text]
|
|
|
|
|
|
C. Valenzuela, E. Delpon, L. Franqueza, P. Gay, O. Perez, J. Tamargo, and D. J. Snyders Class III Antiarrhythmic Effects of Zatebradine: Time-, State-, Use-, and Voltage-Dependent Block of hKv1.5 Channels Circulation, August 1, 1996; 94(3): 562 - 570. [Abstract] [Full Text]
|
|
|
|
|
|
L. Wang, Z.-P. Feng, C. S. Kondo, R. S. Sheldon, and H. J. Duff Developmental Changes in the Delayed Rectifier K+ Channels in Mouse Heart Circ. Res., July 1, 1996; 79(1): 79 - 85. [Abstract] [Full Text]
|
|
|
|
|
|
S. G. Priori, C. Napolitano, F. Cantu, A. M. Brown, and P. J. Schwartz Differential Response to Na+ Channel Blockade, ß-Adrenergic Stimulation, and Rapid Pacing in a Cellular Model Mimicking the SCN5A and HERG Defects Present in the Long-QT Syndrome Circ. Res., June 1, 1996; 78(6): 1009 - 1015. [Abstract] [Full Text]
|
|
|
|
|
|
G.-R. Li, J. Feng, L. Yue, M. Carrier, and S. Nattel Evidence for Two Components of Delayed Rectifier K+ Current in Human Ventricular Myocytes Circ. Res., April 1, 1996; 78(4): 689 - 696. [Abstract] [Full Text]
|
|
|
|
|
|
A. Focaccio, G. Peeters, M. Movsesian, R. Roden, Y. Eki, J. Krall, and M. R. Bristow Mechanism of Action of OPC-8490 in Human Ventricular Myocardium Circulation, February 15, 1996; 93(4): 817 - 825. [Abstract] [Full Text]
|
|
|
|
|
|
G. A. Gintant Two Components of Delayed Rectifier Current in Canine Atrium and Ventricle : Does IKs Play a Role in the Reverse Rate Dependence of ClassIII Agents? Circ. Res., January 1, 1996; 78(1): 26 - 37. [Abstract] [Full Text]
|
|
|
|
|
|
M. W. Veldkamp, A. C.G. van Ginneken, T. Opthof, and L. N. Bouman Delayed Rectifier Channels in Human Ventricular Myocytes Circulation, December 15, 1995; 92(12): 3497 - 3504. [Abstract] [Full Text]
|
|
|
|
|
|
H. J. Duff, Z.-P. Feng, and R. S. Sheldon High- and Low-Affinity Sites for [3H]Dofetilide Binding to Guinea Pig Myocytes Circ. Res., October 1, 1995; 77(4): 718 - 725. [Abstract] [Full Text]
|
|
|
|
|
|
K. Mori, Y. Hara, T. Saito, Y. Masuda, and H. Nakaya Anticholinergic Effects of Class III Antiarrhythmic Drugs in Guinea Pig Atrial Cells : Different Molecular Mechanisms Circulation, June 1, 1995; 91(11): 2834 - 2843. [Abstract] [Full Text]
|
|
|
|
|
|
T. Yang, D. J. Snyders, and D. M. Roden Ibutilide, a Methanesulfonanilide Antiarrhythmic, Is a Potent Blocker of the Rapidly Activating Delayed Rectifier K+ Current (IKr) in AT-1 Cells : Concentration-, Time-, Voltage-, and Use-Dependent Effects Circulation, March 15, 1995; 91(6): 1799 - 1806. [Abstract] [Full Text]
|
|
|
|
|
|
E. Delpon, C. Valenzuela, O. Perez, O. Casis, and J. Tamargo Propafenone Preferentially Blocks the Rapidly Activating Component of Delayed Rectifier K+ Current in Guinea Pig Ventricular Myocytes : Voltage-Independent and Time-Dependent Block of the Slowly Activating Component Circ. Res., February 1, 1995; 76(2): 223 - 235. [Abstract] [Full Text]
|
|