A Review of Commonly Prescribed Antiarrhythmics: Primer for Primary Care Providers, a Case Based Approach

Abstract

The incidence of atrial fibrillation has been steadily increasing as our average population continues to age. In addition, many patients with structural heart disease are on antiarrhythmic drugs for prevention of ventricular tachycardia. General practitioners have a large role in co-management of patients with cardiac disease. The general understanding of common antiarrhythmic drugs and underlying mechanism is pivotal to safely prescribe and follow up of patients as they have potent side effects and drug interactions that needs careful consideration. The decision of which antiarrhythmic medication to use should be personalized, as each patient has a variety of co-morbid conditions that may affect the selection of which drug therapy. The ideal use of antiarrhythmic drugs should focus on understanding the basic pharmacology of the medication. This manuscript is not meant to be an in-depth overview of antiarrhythmic therapy, but rather a review of the commonly used antiarrhythmic drugs to assist primary care practitioners on when to consider antiarrhythmic drugs best suited for their patients. Class I and class III antiarrhythmic drugs will be the focus in this manuscript.