Drugs acting on the heart: anti-arrhythmics

Arrhythmias are common in patients undergoing anaesthesia and surgery, as well as those in intensive care. They are associated with a variety of underlying disorders or disease states. Arrhythmias must be identified promptly and managed appropriately. In many cases, this involves prevention or correction of precipitating factors and sometimes non-pharmacological treatments (cardioversion or surgical ablation); however, anti-arrhythmic drugs are often required. These drugs may be categorized according to their mechanism of action using the Vaughan Williams classification system. However, this is less useful in determining the choice of anti-arrhythmic in clinical practice.