所字 ZnsJiang University Antiarrhythmic Drugs Huifang Tang Department of pharmacology Zhejiang University School of Medicine tanghuifang⊙ ju. edu.cn
Antiarrhythmic Drugs Huifang Tang Department of pharmacology Zhejiang University School of Medicine tanghuifang@zju.edu.cn
所字 ZnsJiang University A. Electrophysiological basis of arrhythmias B. Electrophysiological effects and classification of antiarrhythmic drugs C. Antiarrhythmic drugs D. Proarrhythmic effects of antiarrhythmic drugs
A. Electrophysiological basis of arrhythmias B. Electrophysiological effects and classification of antiarrhythmic drugs C. Antiarrhythmic drugs D. Proarrhythmic effects of antiarrhythmic drugs
A normal rhythm Rs 所字 ZnsJiang University premature ventricular beat 人人人入人 C paroxysmal supraventricular tachycardia (PSVT) D atrial fibrillation arrhythmias v-y E atrial flutter with variable Av conduction Too rapid; +++++++++++4+++++ F atrial flutter with 1: 1 AV conduction Too slow willow Asynchronous G monomorphic ventricular tachycardia Reduce cardiac output H Torsades de Pointes ventricular fibrillation √
arrhythmias Too rapid; Too slow; Asynchronous; Reduce cardiac output
A. Electrophysiological basis of arrhythmias 1. Normal cardiac electrophysiology Excitability: ability to produce action potentials maximal diastolic potentials(MDP) threshold levels Automaticity: pacemaker phase 4 slope Conductivity: conduction pathways phase 0 amplitude
A. Electrophysiological basis of arrhythmias 1. Normal cardiac electrophysiology Excitability: ability to produce action potentials maximal diastolic potentials (MDP) threshold levels Automaticity: pacemaker phase 4 slope Conductivity: conduction pathways, phase 0 amplitude
所字 inward outward 0 ZnsJiang University Phase 4 Na+ current Ca -type current Action T-type transient ITO1 (4-AP-sensitive) potential outward current To2 and ion (Ca2+-activated) transport delayed ctifiers p Fast response ce∥l inward rectifier, Ik1 pacemaker current, If (…, see above Na*-Ca2+ exchange Na′,K+ ATPase
Action potential and ion transport Fast response cell