非传统抗心律失常药物对房颤的治疗

Non-traditional antiarrhythmic medicines for atrial fibrillation

房颤是临床最常见的心律失常类型。但是由于存在较高的心律失常复发率和潜在的致心律失常作用,传统抗心律失常药物的临床治疗效果并不能令人满意。近年来,随着对房颤发生、发展机制的深入研究,以及大量临床试验和动物试验数据的支持,抗炎治疗、抗氧化应激、对肾素-血管紧张素-醛固酮系统(RAAS)的调节、细胞间缝隙连接蛋白功能的调节等有可能成为房颤治疗的新靶点。本文综述了上述几种过程可能涉及的分子机制,以及一系列相关的非离子通道阻断剂的临床试验结果,希望能为抗心律失常药物开发提供新的思路。

Atrial fibrillation is the most common arrhythmia in clinical practice.However,the therapeutic effects of traditional antiarrhythmic medicines are far from satisfactory,because of the high rate of arrhythmia recurrence and the potential proarrhythmia effect.Recently,with the further investigation of the mechanisms that initiate and perpetuate atrial fibrillation,and the support of extensive data from clinical trials and animal experiments,therapeutics based on anti-inflammation,antioxidation,regulation on renin-angiotensin-aldosterone system（RAAS）and gap junction may be new therapeutic targets for the treatment of arrhythmia.In this paper,the potential molecular mechanisms involved in these processes and several clinical trials about some non-traditional antiarrhythmic medicines were reviewed,in order to propose a new idea about the development of antiarrhythmic medicines.