Azimilide - A nonselective class III antiarrhythmic agent for use in atrial fibrillation

Azimilide is a novel, nonselective class III antiarrhythmic agent under FDA review for use in preventing recurrence of symptomatic atrial fibrillation and other arrhythmias. In clinical trials, oral azimilide has been significantly more effective than placebo in prolonging the arrhythmia-free period in patients with a history of atrial fibrillation. Azimilide's unique mechanism of action - blockade of both the rapidly and slowly activating components of the delayed rectifier cardiac potassium current - is believed to contribute to its favorable side-effect profile, specifically the low incidence of torsades de pointes. Unlike amiodarone, azimilide is not associated with serious noncardiac toxicities and does not interact with warfarin or digoxin, The available data suggest that azimilide, if approved, may provide a first line of therapy for preventing recurrence of symptomatic atrial fibrillation.