Azimilide: the first of a new type of class III antiarrhythmic agents

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IN BRIEFAzimilide is a class III antiarrhythmic agent that - unlike other agents of its class - prolongs cardiac repolarisation by blocking both the rapidly (IKr) and slowly (IKs) activating components of the delayed rectifier potassium channel (IK). The most important consequence of this is apparent rate-independent activity, so that, unlike other class III antiarrhythmics, azimilide does not lose efficacy at high heart rates. Azimilide is in late phase clinical trials for the treatment of atrial fibrillation, atrial flutter and paroxysmal supraventricular tachycardia (PSVT). Its efficacy in recent postmyocardial infarction patients at high risk of arrhythmia-induced sudden death is also currently under evaluation. Azimilide is generally well tolerated (most common adverse event is headache) and associated with a low incidence of proarrhythmic events.

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