rotigaptide and celivarone

Antiarrhythmic pharmaceutical development for the treatment of atrial fibrillation (AF) is moving in several directions. The efficacy of existing drugs, such as carvedilol, for rate control and, possibly, suppression of AF, is more appreciated. Efforts are being made to modify existing agents, such as amiodarone, in an attempt to ameliorate safety and adverse effect concerns. This has resulted in promising data from the deiodinated amiodarone analog, dronedarone, and further work with celivarone and ATI-2042. In an attempt to minimize ventricular proarrhythmia, atrial selective drugs, such as intravenous vernakalant, have demonstrated efficacy in terminating AF in addition to promising data in suppression recurrences when used orally. Several other atrial selective drugs are being developed by multiple manufacturers. Other novel therapeutic mechanisms, such as drugs that enhance GAP junction conduction, are being developed to achieve more effective drug therapy than is offered by existing compounds. Finally, nonantiarrhythmic drugs, such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, high-mobility group coenzyme A enzyme inhibitors and omega-3 fatty acids/fish oil, appear to have a role in suppressing AF in certain patient subtypes. Future studies will clarify the role of these drugs in treating AF.

Topics: Adenosine; Adenosine A1 Receptor Antagonists; Adrenergic beta-Antagonists; Amiodarone; Anti-Arrhythmia Agents; Atrial Fibrillation; Benzofurans; Biphenyl Compounds; Bridged Bicyclo Compounds, Heterocyclic; Carbazoles; Carvedilol; Cyclopropanes; Dronedarone; Fatty Acids, Omega-3; Furans; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Oligopeptides; Organic Chemicals; Peptidyl-Dipeptidase A; Potassium Channel Blockers; Propanolamines; Purinergic P1 Receptor Agonists