Clinical guidelines and expert opinion on the use of antiarrhythmic drugs in actual practice

The article provides information only on antiarrhythmic drugs which are widely used in Russian clinical practice and include propafenone, amiodarone, sotalol and lappaconitine. There is a certain number of studies which investigated not only an efficacy but also a safety of each of these drugs. On the one hand, the treatment of arrhythmias in clinical practice has traditionally been considered a challenge because of the abundance of types of arrhythmias, and sometimes because of the aggressive action of antiarrhythmic drugs with the possibility of proarrhythmic and extracardiac complications. On the other hand, we often deal with a comorbid patient who has not only the evident structural disorder of the heart, but also comorbidity that should be considered when selecting the diagnostic algorithm and treatment regimen for a particular heart rhythm disorder. It is important to remember that a key point for a prescription of antiarrhythmic drugs should always be a balance between the efficacy and safety of the drug, since one must clearly realize the purpose of the treatment and take all precautions to avoid even more problems than those for which therapy is performed.

antiarrhythmic therapy, propafenone, amiodarone, sotalol, lappaconitine