Trials of new antiarrhythmic drugs for maintenance of sinus rhythm in patients with atrial fibrillation

Despite the recent results of the AFFIRM trail showing that either strategy of rate control or rhythm control is acceptable, there is general agreement that therapy must be individualized. Antiarrhythmic drugs while being effective in maintaining sinus rhythm are not without side effects. Thus, there continues to be a search for safer and better tolerated agents. Azimilide is a novel class 3 agent that blocks both components of the delayed rectifier current, while dofetilide blocks only the slow component. Dronedarone is somewhat similar to aminodarone, but perhaps with the side effects. Tedisamil is a complex class 3 agent, blocking multiple channels. Piboserod is a selective 5- HT receptor antagonist that is being investigated in clinical trials.