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From articles published in Cardiovascular Prevention and Pharmacotherapy during the past two years (2023 ~ ).

Review Article
Calcium channel blockers for hypertension: old, but still useful
Eun Mi Lee
Cardiovasc Prev Pharmacother. 2023;5(4):113-125.   Published online October 30, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e16
  • 22,979 View
  • 1,196 Download
  • 7 Citations
Abstract PDF
Calcium channel blockers (CCBs) constitute a heterogeneous class of drugs that can be divided into dihydropyridines (DHPs) and non-DHPs. DHP-CCBs are subcategorized into four generations based on the duration of activity and pharmacokinetics, while non-DHP-CCBs are subcategorized into phenylethylamine and benzodiazepine derivatives. DHP-CCBs are vascular-selective and function as potent vasodilators, whereas non-DHP-CCBs are cardiac-selective and are useful for treating tachyarrhythmia, but reduce cardiac contractility and heart rate. Traditional DHP-CCBs (nifedipine) mainly block L-type calcium channels, whereas novel CCBs block N-type (amlodipine) and/or T-type channels (efonidipine) in addition to L-type channels, leading to organ-protective effects. DHP-CCBs have a potent blood pressure–lowering effect and suppress atherosclerosis and coronary vasospasm. Diltiazem, a non-DHP-CCB, is highly effective for vasospasm control. CCBs reduce left ventricular hypertrophy and arterial stiffness. Amlodipine, a DHP-CCB, reduces blood pressure variability. L/N- and L/T-type CCBs combined with renin-angiotensin system blockers reduce proteinuria and improve kidney function compared with L-type CCBs. According to large-scale trials, DHP-CCBs reduce cardiovascular events in patients with isolated systolic hypertension, as well as in elderly and high-risk patients. Accordingly, CCBs are indicated for hypertension in elderly patients, isolated systolic hypertension, angina pectoris, and coronary vasospasm. Non-DHP-CCBs are contraindicated in high-grade heart block, bradycardia (<60 beats per minute [bpm]), and heart failure with reduced ejection fraction (HFrEF). DHP-CCBs should be used with caution in patients with tachyarrhythmia, HFrEF, and severe leg edema, and non-DHP-CCBs should be used carefully in those with constipation. Each CCB has distinct pharmacokinetics and side effects, underscoring the need for meticulous consideration in clinical practice.

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  • Synthesis, Characterization, DFT Analysis, Pharmacokinetics, and Inhibition of Mpro and RdRp of SARS-CoV-2 by Two Dihydropyrimidines Derivatives
    Samia Mammeri, Rachida Kerkour, Nadjib Chafai, Hassina Harkat, Saleh Chafaa
    Journal of Molecular Structure.2025; 1324: 140797.     CrossRef
  • Design of Experimental Approach for Development of Rapid High Performance Liquid Chromatographic Process for Simultaneous Estimation of Metoprolol, Telmisartan, and Amlodipine from Formulation: Greenness and Whiteness Evaluation
    Mahesh Attimarad, Mohammed Jassim Alali, Hussain Ali Alali, Dana Hisham Alabdulmuhsin, Aljohara Khalid Alnajdi, Katharigatta Narayanaswamy Venugopala, Anroop B. Nair
    Molecules.2024; 29(5): 1087.     CrossRef
  • The Evolving Role of Calcium Channel Blockers in Hypertension Management: Pharmacological and Clinical Considerations
    Kamryn E. Jones, Shaun L. Hayden, Hannah R. Meyer, Jillian L. Sandoz, William H. Arata, Kylie Dufrene, Corrado Ballaera, Yair Lopez Torres, Patricia Griffin, Adam M. Kaye, Sahar Shekoohi, Alan D. Kaye
    Current Issues in Molecular Biology.2024; 46(7): 6315.     CrossRef
  • Home blood pressure-lowering effect of esaxerenone versus trichlormethiazide for uncontrolled hypertension: a predefined subanalysis of the EXCITE-HT randomized controlled trial by basal calcium channel blocker versus angiotensin receptor blocker
    Kazuomi Kario, Hiroyuki Ohbayashi, Masami Hashimoto, Naoki Itabashi, Mitsutoshi Kato, Kazuaki Uchiyama, Kunio Hirano, Noriko Nakamura, Takahide Miyamoto, Hirotaka Nagashima, Hidenori Ishida, Yusuke Ebe, Tsuguru Hatta, Toshiki Fukui, Tatsuo Shimosawa, Tomo
    Hypertension Research.2024;[Epub]     CrossRef
  • Endothelial Cell Dysfunction: Onset, Progression, and Consequences
    Hojjat Naderi-Meshkin, Wiwit Ananda Wahyu Setyaningsih
    Frontiers in Bioscience-Landmark.2024;[Epub]     CrossRef
  • Rationale and Design of a Randomized, Open‐Label, Parallel‐Group Study of Esaxerenone Versus Angiotensin Receptor Blockers in Older Patients With Uncontrolled Hypertension on Calcium Channel Blocker Monotherapy (ESCORT‐HT)
    Kazuomi Kario, Tomohiro Katsuya, Tatsuo Shimosawa, Takashi Taguchi, Ayumi Tanabe, Mitsuru Ohishi
    The Journal of Clinical Hypertension.2024;[Epub]     CrossRef
  • Angiotensin II Exposure In Vitro Reduces High Salt-Induced Reactive Oxygen Species Production and Modulates Cell Adhesion Molecules’ Expression in Human Aortic Endothelial Cell Line
    Nikolina Kolobarić, Nataša Kozina, Zrinka Mihaljević, Ines Drenjančević
    Biomedicines.2024; 12(12): 2741.     CrossRef
Original Article
Variation in blood viscosity based on the potential cause of stroke of undetermined etiology
Jinyoung Oh, Youngchan Jung, Jin Kim, Sun Ki Min, Sang Won Han, Jong Sam Baik
Cardiovasc Prev Pharmacother. 2023;5(4):144-150.   Published online October 25, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e14
  • 1,778 View
  • 30 Download
  • 3 Citations
Abstract PDF
Background
This study investigated potential differences in blood viscosity (BV) among patients with stroke of undetermined etiology, negative evaluation (SUDn), specifically those with potential atherothrombosis (SUDn-AT) and those with possible embolism (SUDn-E).
Methods
This single-center study employed a retrospective observational design. The participants were patients over 20 years old with the SUDn stroke subtype who were admitted within 5 days of symptom onset. These patients were categorized as SUDn-AT or SUDn-E. Patients in the SUDn-AT group had nonsignificant stenosis (<50%) of a major brain artery relevant to their symptoms and exhibited one or more signs of systemic atherosclerosis, including atherosclerosis of at least one major brain artery other than those clinically relevant, coronary artery disease, and/or peripheral artery disease. For the SUDn-E group, the SUDn criteria from the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification system were strictly applied.
Results
The final analysis included 153 patients, with 104 (68%) classified as SUDn-E and the remaining 32% as SUDn-AT. Patients in the SUDn-AT group had a higher systolic BV (P=0.012) and diastolic BV (P=0.020) than those in the SUDn-E group. Multivariable logistic regression analysis revealed that age (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.03–1.13; P=0.003), systolic BV (OR, 3.11; 95% CI, 1.41–6.85; P=0.005), and diastolic BV (OR, 1.08; 95% CI, 1.02–1.14; P=0.009) were associated with SUDn-AT.
Conclusions
Within the TOAST system, two SUDn entities may be distinguishable, with potentially different underlying etiologies: atherothrombosis and embolic stroke of undetermined source.

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  • Association of Cerebral Artery Stenosis with Blood Viscosity in Patients with Transient Ischemic Attack
    Young Chan Jung, Sang Won Han, Joong Hyun Park
    Journal of Neurosonology and Neuroimaging.2024; 16(1): 8.     CrossRef
  • A Comprehensive Study of Risk Factors, Etiology, and Infarction Patterns in Cerebrovascular Accidents at a Tertiary Care Hospital in India
    Raju Hansini Reddy, Pradnya Diggikar, Mayank Mundada, Arun Oommen, Tushar Pancholi, Bhavya Yammanuru, Sree Vidya Yekkaluru, Advit Sangwan
    Cureus.2024;[Epub]     CrossRef
  • The Effect of Organic Vegetable Mixed Juice on Blood Circulation and Intestine Flora: Randomized, Double-Blinded, Placebo-Controlled Clinical Trial
    Yun-Ha Lee, Jae-Ho Lee, Soo-Min Jeon, Il-Kyu Park, Hyun-Bin Jang, Soo-A Kim, Soo-Dong Park, Jae-Jung Shim, Seong-Soo Hong, Jae-Hwan Lee
    Diseases.2024; 12(9): 223.     CrossRef
Review Article
Decision-making for recurrent atrial fibrillation after catheter ablation
Jum Suk Ko, Sung Soo Kim, Hyung Ki Jeong, Nam Ho Kim
Cardiovasc Prev Pharmacother. 2023;5(4):102-112.   Published online October 27, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e15
  • 18,763 View
  • 319 Download
  • 2 Citations
Abstract PDF
Catheter ablation for atrial fibrillation (AF), especially pulmonary vein (PV) isolation, is widely used for rhythm control. However, AF recurrence remains a challenge, affecting 20% to 50% of cases. This review focuses on AF recurrence after catheter ablation. AF recurrence can be categorized into early recurrence (ER) within 3 months after index procedure, late recurrence (LR) within 1 year, and very LR (VLR) occurring beyond 1 year. ER has emerged as a significant predictor of LR, contrary to the traditional understanding. LR is primarily caused by PV reconnection, while VLR more involves non-PV triggers or substrates. Managing AF recurrence includes antiarrhythmic drugs, steroids, colchicine, and repeat ablation. Antiarrhythmic drugs reduce ER but have a limited impact on LR. Steroids have been shown to reduce ER, but not long-term recurrence. Colchicine, an anti-inflammatory agent, shows promise in reducing both ER and LR, although further research is necessary. Whether to perform early repeat ablation after ER remains uncertain, as not all patients require immediate intervention. In conclusion, AF recurrence after ablation remains a complex issue. Understanding the underlying mechanisms is essential for personalized management. Tailored approaches, considering individual characteristics, are crucial for long-term success. Future research should focus on improving therapeutic strategies for AF recurrence.

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  • Meta-analysis of Pulsed Field Ablation Versus Thermal Ablation for Pulmonary Vein Isolation in AF: A Broad Overview Focusing on Efficacy, Safety and Outcomes
    Mohammad Iqbal, William Kamarullah, Raymond Pranata, Iwan Cahyo Santosa Putra, Giky Karwiky, Chaerul Achmad, Young Hoon Kim
    Arrhythmia & Electrophysiology Review.2024;[Epub]     CrossRef
  • Beyond Clinical Factors: Harnessing Artificial Intelligence and Multimodal Cardiac Imaging to Predict Atrial Fibrillation Recurrence Post-Catheter Ablation
    Edward T. Truong, Yiheng Lyu, Abdul Rahman Ihdayhid, Nick S. R. Lan, Girish Dwivedi
    Journal of Cardiovascular Development and Disease.2024; 11(9): 291.     CrossRef
Original Article
Changes in cardiovascular-related health behaviors during the COVID-19 pandemic
Eunji Kim, Chan-Hee Jung, Dae Jung Kim, Seung-Hyun Ko, Hae-Young Lee, Kyung-Yul Lee, Dae Ryong Kang, Sung Kee Ryu, Won-Young Lee, Eun-Jung Rhee, Hyeon Chang Kim
Cardiovasc Prev Pharmacother. 2023;5(1):15-23.   Published online January 27, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e2
  • 3,551 View
  • 51 Download
  • 2 Citations
Abstract PDFSupplementary Material
Background
The COVID-19 pandemic has been the most pressing health challenge in recent years. Meanwhile, prevention for other diseases, such as cardiovascular disease (CVD) has been less prioritized during the pandemic. COVID-19, a novel infectious disease, both had a direct impact on public health and provoked changes in health-related behaviors, including those for CVD prevention. This study sought to examine changes in CVD-related health behaviors during the COVID-19 pandemic and related sociodemographic factors.
Methods
We used data from the Cardiovascular Disease Prevention Awareness Survey conducted in Korea in June 2022. A total of 2,000 adults across Korea’s 17 provinces completed a structured questionnaire online or on a mobile device. Self-reported changes in CVD-related health behaviors were investigated. We used unadjusted and adjusted logistic regression models to explore the associations between negative changes and sociodemographic factors.
Results
In smoking, drinking, and healthcare service use, the proportion of those with positive changes surpassed the proportion of respondents who reported negative changes. In contrast, negative changes predominated for diet, exercise, and stress. Most individuals (52.6%) reported a deterioration of psychological distress. These negative changes were significantly associated with age, sex, marital status, and the presence of cardiometabolic disease.
Conclusions
The COVID-19 pandemic has affected CVD-related health behaviors. Based on these changes, CVD prevention should be encouraged with appropriate and prioritized strategies.

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  • Changes in cardiovascular-related health behaviors after the end of social distancing: the 2023 Cardiovascular Disease Prevention Awareness Survey
    Jaeyong Lee, Eunji Kim, Won-Young Lee, Eun-Jung Rhee, Hyeon Chang Kim
    Cardiovascular Prevention and Pharmacotherapy.2024; 6(2): 57.     CrossRef
  • Cardiovascular-related health behavior changes: lessons from the COVID-19 pandemic and post-pandemic challenges
    Inha Jung, Won-Young Lee
    Cardiovascular Prevention and Pharmacotherapy.2023; 5(4): 99.     CrossRef
Review Articles
The emergence and clinical significance of artificial intelligence–enhanced electrocardiography
Yong-Soo Baek
Cardiovasc Prev Pharmacother. 2024;6(2):41-47.   Published online April 26, 2024
DOI: https://doi.org/10.36011/cpp.2024.6.e7
  • 2,488 View
  • 65 Download
  • 1 Citations
Abstract PDF
The integration of artificial intelligence (AI) with electrocardiography (ECG), a technology known as AI-ECG, represents a transformative leap in the field of cardiovascular medicine. This innovative approach has significantly advanced the capabilities of ECG, traditionally used for diagnosing heart diseases. AI-ECG excels in detecting subtle changes and interconnected patterns in cardiac waveforms, offering a level of precision and sensitivity that was previously unattainable with conventional methods. The scope of AI-ECG extends beyond the realm of heart diseases. It has shown remarkable potential in predicting and identifying the impacts of noncardiac conditions on heart health, thereby broadening the diagnostic capabilities of ECG. This is especially valuable given the complex nature of cardiovascular diseases and their interactions with other health conditions. Despite its groundbreaking potential, AI-ECG faces several challenges. One of the primary concerns is the "black box" nature of AI algorithms, which can make the decision-making process opaque and difficult to interpret. This poses a challenge in medical settings where understanding the rationale behind a diagnosis is crucial. Additionally, the effectiveness of AI-ECG is dependent on the quality and diversity of the datasets used to train the algorithms. Limited or biased datasets can lead to inaccuracies and diminish the reliability of the technology. However, the benefits of AI-ECG are significant. It enables faster, more accurate diagnoses and has the potential to greatly enhance the efficiency of cardiovascular care. As research and technology continue to evolve, AI-ECG is poised to become an indispensable tool in the diagnosis and management of heart diseases.

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  • AI-Enhanced ECG Applications in Cardiology: Comprehensive Insights from the Current Literature with a Focus on COVID-19 and Multiple Cardiovascular Conditions
    Luiza Camelia Nechita, Aurel Nechita, Andreea Elena Voipan, Daniel Voipan, Mihaela Debita, Ana Fulga, Iuliu Fulga, Carmina Liana Musat
    Diagnostics.2024; 14(17): 1839.     CrossRef
COVID-19 vaccination–related cardiovascular complications
Jae Yeong Cho, Kye Hun Kim
Cardiovasc Prev Pharmacother. 2023;5(4):134-143.   Published online October 27, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e17
  • 2,603 View
  • 37 Download
  • 1 Citations
Abstract PDF
The global response to the COVID-19 pandemic has led to rapid vaccine development and distribution. As vaccination efforts continue, concerns have arisen regarding potential adverse events associated with COVID-19 vaccination. This article examines emerging evidence on adverse events, including myocarditis, pericarditis, and thrombotic complications, in relation to COVID-19 vaccination. Reports of myocarditis and pericarditis cases following messenger RNA vaccines have sparked interest, with discussions revolving around potential mechanisms and genetic predispositions. The contrasting findings on pericarditis risk postvaccination highlight the complexity of studying this phenomenon. Thrombotic events, particularly vaccine-induced thrombotic thrombocytopenia, have garnered attention, prompting investigations into antibody responses and mechanisms. This article underscores the importance of ongoing research, collaboration, and data analysis for accurately understanding adverse events. While the COVID-19 vaccination campaign may have ended, it is still vital to maintain vigilance, collect comprehensive data and foster interdisciplinary collaboration to uphold vaccine safety and steer public health strategies in the upcoming period.

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  • The Role of COVID-19 Vaccination for Patients With Atherosclerotic Cardiovascular Disease in the Upcoming Endemic Era
    Kye Hun Kim
    Journal of Lipid and Atherosclerosis.2024; 13(1): 21.     CrossRef
Original Article
Correlation between metformin intake and prostate cancer
Raeun Kim, Minsun Song, Jiwon Shinn, Hun-Sung Kim
Cardiovasc Prev Pharmacother. 2023;5(3):91-97.   Published online July 31, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e12
  • 3,980 View
  • 53 Download
  • 1 Citations
Abstract PDF
Background
The relationship between metformin intake and prostate cancer incidence remains unclear. Therefore, we examined the correlation between prostate cancer and metformin use.
Methods
The subjects were diabetes patients aged ≥50 years who had been diagnosed with prostate cancer and had undergone surgery at Seoul St. Mary's Hospital. Groups taking metformin (MET(+) group) and not taking metformin (MET(–) group) were divided and compared.
Results
The mean preoperative prostate-specific antigen (PSA) levels in the MET(–) and MET(+) groups were 10.7±11.9 and 8.0±5.6 ng/mL, respectively, with no statistically significant difference between the two groups (P=0.387). The average prostate volume of the MET(–) group was 82.4±98.0 mL, and the average prostate volume of the MET(+) group was 55.4±20.1 mL, but there was no statistically significant difference between the two groups (P=0.226). The mean PSA velocity also did not show a significant difference between the two groups (0.025±0.102 ng/mL vs. 0.005±0.012 ng/mL, P=0.221).
Conclusions
We did not identify a significant positive correlation between metformin and prostate cancer. However, preoperational PSA and PSA velocity tended to be lower in the MET(+) group. A sophisticated prospective study with a large sample size should be planned.

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  • Metformin: Beyond Type 2 Diabetes Mellitus
    Rahnuma Ahmad, Mainul Haque
    Cureus.2024;[Epub]     CrossRef
Review Articles
Diabetes mellitus and cancer
Jae Won Hong
Cardiovasc Prev Pharmacother. 2023;5(3):69-73.   Published online July 27, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e9
  • 3,815 View
  • 138 Download
  • 1 Citations
Abstract PDF
Diabetes mellitus and cancer are the most common life-threatening illnesses worldwide. Previous epidemiological studies have suggested a strong association between diabetes mellitus and an increased risk of cancer. Potential biological mechanisms underlying this relationship include obesity, hyperglycemia, hyperinsulinemia, chronic inflammation, and oxidative stress. The most common diabetes-related cancers are pancreatic, hepatocellular, breast, endometrial, and colorectal cancer. Special attention should be paid to patients with diabetes through careful cancer screening and preventive anticancer strategies.

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  • Repurposing metabolic regulators: antidiabetic drugs as anticancer agents
    Yogita Dhas, Nupur Biswas, Divyalakshmi M.R., Lawrence D. Jones, Shashaanka Ashili
    Molecular Biomedicine.2024;[Epub]     CrossRef
Research on obesity using the National Health Information Database: recent trends
Eun-Jung Rhee
Cardiovasc Prev Pharmacother. 2023;5(2):35-40.   Published online April 28, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e8
  • 2,422 View
  • 50 Download
  • 1 Citations
Abstract PDF
The prevalence of obesity has increased markedly in Korea during the past few decades. Korea is one of the most well-organized countries in terms of its National Health Insurance System (NHIS), which conducts screening examinations. Since the NHIS is unified and managed by the government, its data—contained in the National Health Insurance Database (NHID)—are centralized. The Korean government has recently encouraged researchers to access the NHID, conduct research, and write papers to convey their findings. Expanded research using the NHID could shed light on the future of big data research. In this review, I would like to present an overview of current trends in obesity research using the NHID.

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  • Income-Related Disparities in Mortality Among Young Adults With Type 2 Diabetes
    Ji Yoon Kim, Sojeong Park, Minae Park, Nam Hoon Kim, Sin Gon Kim
    JAMA Network Open.2024; 7(11): e2443918.     CrossRef
Original Article
Modifiable risk factors for coronary artery disease in the Indonesian population: a nested case-control study
Anggoro Budi Hartopo, Maria Patricia Inggriani, Brilliant Winona Jhundy, Jajah Fachiroh, Putri Tiara Rosha, Ratri Kusuma Wardani, Fatwa Sari Tetra Dewi
Cardiovasc Prev Pharmacother. 2023;5(1):24-34.   Published online January 31, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e3
  • 3,817 View
  • 144 Download
  • 1 Citations
Abstract PDF
Background
There is a lack of data on modifiable coronary artery disease (CAD) risk factors in the Indonesian population, hindering the implementation of assessments and prevention programs in this population. This study investigated modifiable risk factors for CAD among Indonesians by comparing them between CAD-proven patients and healthy subjects from a similar population.
Methods
In this nested, matched case-control study, the cases were patients from a referral hospital in Yogyakarta, Indonesia and the controls were respondents in a population surveillance system in Yogyakarta, Indonesia. The cases were 421 patients who had undergone coronary angiography, showing significant CAD. The sex- and age-matched controls were 842 respondents from the Universitas Gadjah Mada Health and Health and Demographic Surveillance System Sleman who indicated no CAD presence on a questionnaire. The modifiable CAD risk factors compared between cases and controls were diabetes mellitus, hypertension, central obesity, smoking history, physical inactivity, and less fruit and vegetable intake. A multivariate regression model was applied to determine independent modifiable risk factors for CAD, expressed as adjusted odds ratios (AORs).
Results
A multivariate analysis model of 1,263 subjects including all modifiable risk factors indicated that diabetes mellitus (AOR, 3.32; 95% confidence interval [CI], 2.09–5.28), hypertension (AOR, 2.52; 95% CI, 1.76–3.60), former smoking (AOR, 4.18; 95% CI, 2.73–6.39), physical inactivity (AOR, 15.91; 95% CI, 10.13–24.99), and less fruit and vegetable intake (AOR, 5.42; 95% CI, 2.84–10.34) independently and significantly emerged as risk factors for CAD.
Conclusions
Hypertension, diabetes mellitus, former smoking, physical inactivity, and less fruit and vegetable intake were independent and significant modifiable risk factors for CAD in the Indonesian population.

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  • Metabolic Syndrome and Abnormal Electrocardiographic Frontal QRS-T Angle in Indonesian Patients
    Effika Nurningtyas Putri, Erika Maharani, Jajah Fachiroh, Fatwa Sari Tetra Dewi, Anggoro Budi Hartopo
    CardioMetabolic Syndrome Journal.2025;[Epub]     CrossRef
Review Article
Adverse reactions to antiarrhythmic drugs
Ungjeong Do
Cardiovasc Prev Pharmacother. 2023;5(1):1-14.   Published online January 16, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e1
  • 65,535 View
  • 270 Download
  • 1 Citations
Abstract PDF
There are various types of adverse reactions to antiarrhythmic drugs (AADs). Proarrhythmia, which refers to an exacerbation of the preexisting arrhythmia or occurrence of a new arrhythmia, may occur under the therapeutic concentration of an AAD. Bradyarrhythmia is the most common type of proarrhythmia due to AADs, and prior myocardial infarction and old age are known risk factors. Atrial flutter with 1:1 atrioventricular conduction usually occurs during rhythm control of atrial fibrillation with class IC AADs. QT prolongation due to AADs, mainly class III AADs, elevates the risk of torsade de pointes by triggered activity due to early afterdepolarization. The addition of clinical factors that promote QT prolongation, such as hypokalemia, hypomagnesemia, female sex, and bradycardia, increases the risk of developing torsade de pointes. Proarrhythmic monomorphic ventricular tachycardia usually occurs as a result of slow conduction and disparity of refractoriness due to class IC AADs. In patients with preexisting left ventricular systolic dysfunction or structural heart disease, the risk of hypotension or cardiogenic shock caused by negative inotropic effects due to AADs should be considered. To prevent these major adverse reactions to AADs, we need to understand the electrophysiologic properties of AADs in detail. Furthermore, the risk of proarrhythmia could be heightened by interplay with clinical factors, such as electrolyte unbalances, heart rate, and hepatic/renal or myocardial dysfunction. Sufficient awareness about drug-drug interactions, which may affect the metabolism of AADs, will improve patient safety during the management of arrhythmia.

Citations

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  • Catheter ablation vs antiarrhythmic therapy for atrial fibrillation in heart failure with preserved ejection fraction
    Marisa R. DeLuca, Bilal Ali, Yasir Tarabichi, Beni R. Verma, Saima Karim
    Heart Rhythm.2024;[Epub]     CrossRef

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