Antiarrhythmic drugs are widely used, but are of modest efficacy and have important side effects. However, even with the advance of catheter ablation for atrial fibrillation and ventricular tachycardia, antiarrhythmic drugs remain an important tool for treating arrhythmias. Antiarrhythmic drug development has remained slow despite much effort given our limited understanding of what role various ionic currents play in arrhythmogenesis and how they are modified by arrhythmias. This review will focus on promising new antiarrhythmic drugs undergoing clinical investigation or currently approved for clinical use, including amiodarone analogues, agents with novel ionic targets, and new drug combinations.