Proarrhythmic and Torsadogenic Effects of Potassium Channel Blockers in Patients

Card Electrophysiol Clin. 2016 Jun;8(2):481-93. doi: 10.1016/j.ccep.2016.02.009. Epub 2016 Mar 22.

Abstract

The most common arrhythmia requiring drug treatment is atrial fibrillation (AF), which affects 2 to 5 million Americans and continues to be a major cause of morbidity and increased mortality. Despite recent advances in catheter-based and surgical therapies, antiarrhythmic drugs continue to be the mainstay of therapy for most patients with symptomatic AF. However, many antiarrhythmics block the rapid component of the cardiac delayed rectifier potassium current (IKr) as a major mechanism of action, and marked QT prolongation and pause-dependent polymorphic ventricular tachycardia (torsades de pointes) are major class toxicities.

Keywords: Arrhythmia; Potassium channel blocker; Torsades de pointes.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anti-Arrhythmia Agents* / pharmacology
  • Anti-Arrhythmia Agents* / therapeutic use
  • Arrhythmias, Cardiac* / drug therapy
  • Arrhythmias, Cardiac* / physiopathology
  • Electrocardiography
  • Female
  • Humans
  • Male
  • Potassium Channel Blockers* / pharmacology
  • Potassium Channel Blockers* / therapeutic use
  • Torsades de Pointes

Substances

  • Anti-Arrhythmia Agents
  • Potassium Channel Blockers