Antiarrhythmic Medications

Your Care Explained > Medications : Antiarrhythmic Medications

Four types of medications can be used to treat arrhythmias, or abnormal heart rhythms. Which ones are prescribed for you depends on whether your disorder originates in the atrium or ventricles of the heart, as well as the characteristics and severity of the rhythm disturbance.

How Antiarrhythmics Work

All antiarrhythmics act on the heart’s ion channels, in which electrically charged molecules—sodium, potassium, magnesium and calcium—travel to stimulate the heart’s contractions. Each class of antiarrhythmics works in a different way. Many of the medications used to treat arrhythmias are also used to treat other cardiovascular conditions, including high blood pressure and heart failure.

Class I Antiarrhythmics

Class I antiarrhythmics block sodium ion channels, decreasing the rate at which the electrical signal travels from cell to cell in the heart muscle. There are three sub-classes, each of which works slightly differently.

Class II Antiarrhythmics

These drugs, beta-blockers, are widely used to treat hypertension and angina, to prevent bleeding in people with liver disease, and to prevent complications from coronary artery bypass surgery. They regulate heartbeat by slowing the response to certain nerve impulses. They include propranolol and metoprolol.

Class III Antiarrhythmics

Probably the most successful in treating arrhythmias, class III medications lengthen recharge time without affecting the heart’s normal electrical conduction. They act in both the upper and lower chambers of the heart. This class includes amiodarone.

Class IV Antiarrhythmics

These medications, verapamil and diltiazem, are calcium channel blockers and are often used to treat high blood pressure. They work by dilating blood vessels and decreasing the heart’s pumping strength.

Special Considerations for Women

Tamoxifen, as well as some drugs to treat migraine and depression, when used in conjunction with amiodarone, may cause life-threatening rhythm disturbances. Be sure to give your doctor a list of all the medications you are taking.

Date Last Modified: January 21, 2011

Send Feedback To: BWH Women’s Health at bwhteleservices@partners.org

75 Francis Street, Boston, MA 02115 617.732.5500
harvard medical school partners healthcare © BWH 2011