Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.15.1 (ACE)
 18,300 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cardiac arrhythmias are a common problem in the perioperative period. The incidence found in the current literature varies depending on the population studied and the definition of arrhythmia used. Overall supraventricular arrhythmias, namely atrial fibrillation, are the most common form. Because of its broad spectrum amiodarone is often used to suppress supraventricular and ventricular arrhythmias. It is believed to be safe for treating patients with severe cardiac disease and it has less proarrhyhmogenic potential than many other antiarrhythmic drugs. However, the use of amiodarone is limited by its cardiac and non-cardiac adverse effects, such as life-threatening bradycardia, pulmonary fibrosis or thyrotoxicosis. According to the guidelines of the American Heart Association, amiodarone can be used to treat atrial fibrillation. Because spontaneous conversion rates in the perioperative setting are high and the advantage of a rhythm control strategy over rate control is questionable, a rate control strategy using less toxic drugs like beta blockers or calcium channel blockers should be preferred in hemodynamically stable patients. The current guidelines of the European Resuscitation Council (ERC) recommend amiodarone to treat hemodynamically stable ventricular tachycardia and in this setting ajmaline is also highly effective. Amiodarone should be administered to patients with cardiac arrest if ventricular tachycardia or ventricular fibrillation persists after three attempts at defibrillation. Dronedarone is a derivate of amiodarone with a similar mechanism of action but with less non-cardiac side effects and is currently being tested in clinical trials. The use of the atrial-specific potassium channel blockers AZD7009 and vernakalant are also being investigated. Furthermore, the role of statins, ACE inhibitors and angiotensin receptor blockers in the prevention of atrial fibrillation has to be evaluated.
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PMID:[Amiodaron for treatment of perioperative cardiac arrythmia: a broad spectrum antiarrythmetic agent?]. 1870 41

Pharmacotherapy of atrial fibrillation (AF) is demanding, because currently available antiarrhythmic drugs have low efficacy and many side effects. In drug development, the focus has been on amiodarone-like multichannel blockers, atrial-specific ion channel blockers, and novel non-channel agents targeting atrial remodelling. Dronedarone, an amiodarone analogue without iodine, was recently approved for treatment of AF. It is less effective than amiodarone, but serious adverse events are rare. Vernakalant, an atrial-selective drug with low proarrhythmic risk, is effective in cardioversion and it may also prevent AF recurrences. So-called upstream therapy with angiotensin converting enzyme and angiotensin receptor inhibitors, statins and omega-3 fatty acids needs further clinical validation.
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PMID:[New antiarrhythmic drugs for treatment of atrial fibrillation]. 2108 84