New grouping of arrhythmia drugs could lead to more precise treatment

Reclassification of antiarrhythmic medicines could aid future drug development and improve clinical guidelines, researchers say.

21 December 2018, by Siobhan Chan

ECG showing atrial fibrillation 

A new classification system for antiarrhythmic drugs could help clinicians to make better treatment decisions for patients.

Developed by researchers from the BHF Centres for Research Excellence at the Universities of Oxford and of Cambridge, the new system expands the number of antiarrhythmic drug groups from five to eight. Study authors say this should improve treatment guidelines and drug development pathways.

Antiarrhythmic drugs, used to treat cardiac arrhythmias such as atrial fibrillation (AF), have been classified using the Vaughan Williams system for nearly 50 years. It is used worldwide to guide treatment and the development of new drugs.

But since this system was created, many more antiarrhythmic drugs have been developed, and their mechanisms of action are better understood, say the researchers who developed the new classification.

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Whereas the Vaughan Williams classification groups antiarrhythmic drugs into five main classes, the new classification uses eight. Authors said their “modernised” classification incorporates medical advances in the past half-century, while preserving the “basic simplicity” of the Vaughan Williams framework.

Their study, published in Circulation, assessed how antiarrhythmic drugs work and grouped them together based on these mechanisms.

Authors said their system will aid “precise treatment decisions” in clinical practice.

They added: “The new classification will aid identification and development of future new anti-arrhythmic drugs, with new discovery strategies relating their potential clinical applications to their molecular mechanisms of action.”


What are the key issues around AF management for primary care staff? Our CPD-accredited guide to managing atrial fibrillation in primary care breaks down some of the challenges.