A matrical approach to the basic and clinical pharmacology of antiarrhythmic drugs

The lethal cardiac arrhythmias remain a major public health problem and their treatment is a major challenge to the clinician. We possess rapidly increasing knowledge of the electrophysiologic events which underly arrhythmogenesis and the antiarrhythmic as well as the proarrhythmic actions of drugs. Much of this electrophysiologic knowledge is irrelevant to the practicing physician. While complex, we believe that the matrical approach provides the clinician with a useful intellectual framework within which to consider the actions of arrhythmogenic influences and antiarrhythmic drugs. The matrical approach is scientifically sound, reflects clinical realities, and serves as a rational guide to the treatment of cardiac arrhythmias. The traditional classifications of antiarrhythmic drugs have served a useful purpose, but they are clearly outmoded.