New Pharmacological Agents for Arrhythmias

Ivabradine in Combination With Metoprolol Succinate in the Treatment of Inappropriate Sinus Tachycardia

“…[5][6][7] In such circumstances a new selective inhibitor of I f channels became an attractive alternative for patients with IST. 1,8 Several studies have described the benefit of ivabradine in patients with drug refractory, highly symptomatic IST. 9-13 A recently published study by Calò et al showed a significant reduction in medium HR and maximal HR (assessed by 24-hour ECG) after 3 to 6 months treatment with ivabradine in patients affected by IST.…”

“…Phosphenes have also been reported in patients during drugs administration, especially a hallucinogen or ivabradine. 8,15,16 The important advantage of ivabradine over b-blockers is the lack of influence on systolic ventricular function, blood pressure, and lipid or glucose metabolism. 8,15,16 In most patients, therefore, the maximal daily dose of ivabradine can be administered for HR control.…”

“…It reduces HR at rest and during exercise without influence on intraventricular conduction, contractility, or hemodynamics. 8 The expression of I f in the sinoatrial node makes ivabradine a promising treatment option in patients with IST. Several studies have suggested that monotherapy with ivabradine is a safe and effective second-line therapy in patient affected by IST; however, some patients may remain symptomatic.…”

Pharmacokinetic and pharmacodynamic profile of dronedarone, a new antiarrhythmic agent for the treatment of atrial fibrillation

“…As a rate control agent, dronedarone has been shown to reduce the mean 24-h ventricular rate response during recurrent or permanent AF and the ventricular rate response during peak exercise [16,17,29]. The mechanisms responsible for the reduction in ventricular rate remain unclear.…”

Early management of atrial fibrillation: from imaging to drugs to ablation

“…80 However, as cumulative toxicity takes years to manifest, the chronic safety profile of dronedarone cannot be determined for some time. 84 a major limitation of develop ing any antiarrhythmic drug is the establishment of its safety profile, and it is difficult for these drugs to enter the market owing to the length and rigor of investigational protocols. However, the encouraging results from studies of dronedarone show us that, although difficult, new drugs with specific targets and improved efficacy are not impossible.…”