Atrial fibrillation: from ion channels to bedside treatment options

Atrial fibrillation is now the most common arrhythmia in clinical practice. Recent understanding of the abnormalities in ion flow that underlie atrial fibrillation has led to the search for new treatment options with improved efficacy and tolerability. The purpose of this article is to review the role of ion channels in the development of atrial fibrillation and discuss the nature of their inhibition by investigational antiarrhythmic agents. Novel treatments include the benzofuran derivative dronedarone, atrial-selective compounds (eg, vernakalant), multichannel blocking agents (eg, tedisamil), and gap junction modifiers (eg, rotigaptide). Targeted antiarrhythmic therapies have the potential to provide safer and more effective management options for patients with atrial fibrillation.