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  5. Cardiology (BM3501)

Lecture notes

cardiac arrhythmias
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Revision of the cardiac action potential and conduction. Potential mechanisms of arrhythmias. Drugs used in the treatment of arrhythmias will be examined at a cellular and systems level.

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  • June 28, 2023
  • 9
  • 2022/2023
  • Lecture notes
  • Derek scott
  • Cardiac arrhythmias

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Cardiac Arrhythmias
Lecture Notes

Categories of Disturbances in Cardiac Rhythm
Delayed after-depolarisation

Re-entry

Abnormal pacemaker activity

heart block

Classification of Anti-Arrhythmic Drugs (Vaughn-
Williams Classification)
Class I → sodium (Na+) channel blockers
→ membrane - stabalising agents

How it works

Binds to Na+ channels → prevent conduction of ions

The more the heart is used the more the drug binds

binds preferentially to open channel state (use dependant)

3 sub classes

Class IA

Moderate blocker

moderately depress phase 0 of
cardiac AP → prolonged
depolarisation by limiting excitation

↓ slope of phase 4 depolarisation →
shift threshold voltage towards 0

↑ fibrillation threshold in atria
and ventricles



Cardiac Arrhythmias 1

, harder to have a heart rhythm
→ harder to fibrilate

↓ or block AV node conduction

used to treat atrial fibrillation (AF)

↑ effective refractory period (ERP)

Example

Quinidine

Procainamide

Disopyramide

It inhibits the fast sodium
channels

Class IB

Weak blocker

minimal phase 0 depression →
slows conduction

shortens repolarisation

used to treat ventricular arrhythmias

↓ ERP → little effect on refractoriness /
responsiveness

Example

Lignocaine (Lidocaine)

local anaesthetic

stabilising the neuronal
membrane by inhibiting the
ionic fluxes required for the
initiation and conduction of
impulses, thereby effecting local
anaesthetic action

acts on sodium ion channels
located on the internal surface
of nerve cell membranes


Cardiac Arrhythmias 2

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