Azimilide dihydrochloride: a unique class III antiarrhythmic agent.

The introduction of class III (Vaughn Williams classification) antiarrhythmic agents has improved the available drug treatment modalities for managing cardiac supraventricular and ventricular tachyarrhythmia. An appreciation of the importance of the delayed rectifier potassium current in the pathogenesis of various cardiac arrhythmias has led to the development of azimilide, an oral type III potassium channel blocker agent that blocks both the rapid activating component (I(kr), common to sotalol, amiodarone, and ibutilide) and the slow activating component (I(ks), a unique action of azimilide) of the delayed rectifier potassium current. Both preclinical and clinical studies have demonstrated the efficacy of azimilide and its safety in the management of supraventricular and ventricular tachyarrhythmia. Azimilide also is being studied in a worldwide multicenter trial for prevention of sudden cardiac death in patients after myocardial infarction. Azimilide soon will become available for clinical use as a treatment for preserving normal sinus rhythm in patients with atrial fibrillation and paroxysmal atrial tachycardia.