上海交通大学：《药理学 Pharmacology》课程教学资源（讲义课件）抗心律失常药物 Anti-Arrhythmic Drug

为 上游充通大学 SHANGHAI JIAO TONG UNIVERSITY 1896 1920 1987 2006 漏 Anti-Arrhythmic Drug HANGHALIIAO TONG UNIVERSIT 叠AA

Anti-Arrhythmic Drug

上浒充通大 SHANGHAI JIAO TONG UNIVERSITY 1896 1920 1987 2006 Content Physiology of normal cardiac rhythm Definition and mechanisms of arrhythmias o Classification of drugs to treat arrhythmias Important anti-arrhythmic drugs (mechanism and pharmacological characteristics) Arrhythmias in clinical practice IAO TONG

Content  Physiology of normal cardiac rhythm  Definition and mechanisms of arrhythmias  Classification of drugs to treat arrhythmias  Important anti-arrhythmic drugs (mechanism and pharmacological characteristics)  Arrhythmias in clinical practice

上浒充通大学 SHANGHAI JIAO TONG UNIVERSITY 1896 1920 1987 2006 Cardiac electrical activity and ECG Lead ll Sinus Node Atrium Left Bundle Branch AV Node Bundle of HIS Ventricles Right Bundle Branch NG UNT

Cardiac electrical activity and ECG

7 图 上浒充通大学 SHANGHAI JIAO TONG UNIVERSITY 1896 1920 1987 2006 Ion channels and AP 1 INa-ca 2 ITot 0 Na HANGHALIAO TONG UNIN lkt 3 A l 4

Ion channels and AP 0 1 2 3 4 INa ICa.L IKr IKs IK1 IK1 ITo1 INa-Ca

上游充通大 2 SHANGHAI JIAO TONG UNIVERSITY 87 2006 inward outward Phase 4 Na+current Ca2+ L-type current T-type transient ITot (4-AP-sensitive) outward current lro2 (Ca2+-activated) delayed rectifiers Ikr (lK) la or Ikp inward rectifier,Ik1 pacemaker current,I (....see above) Na+-Ca2+exchange Na',K+-ATPase

⑧ 上浒充通大学 SHANGHAI JIAO TONG UNIVERSITY 1896 1920 1987 2006 Heterogeneous APs in heart Action Potentials SA Node Atrial Muscle A-V Node His Bundle HB Branches Purkinje Fibers Ventricular Muscle QRS 0.2 0.4s 0.6

Heterogeneous APs in heart

上游充通大 SHANGHAI JIAO TONG UNIVERSITY 1896 1920 1987 2006 NANGHALJIAO TONG OS INa/Ca ICa(L) If. Ik Ica(T) Currents underlying depolarization in SA nodal cells

（Currents underlying depolarization in SA nodal cells ）

上降充通大警 SHANGHAI JIAO TONG UNIVERSITY 1896 1920 1987 2006 Cardiac arrhythmias Tachy-cardiac arrhythmias -Atrial-premature beats -Atrial flutter -Atrial fibrillation (AF) -Ventricular-premature beats (contractions) -Ventricular-tachycardia (VT) -Ventricular fibrillation (VF) Brady-cardiac arrhythmias -Bundle branch blocks -Sinus bradycardia(Sick Sinus Syndrome)

Cardiac arrhythmias Tachy-cardiac arrhythmias -Atrial-premature beats -Atrial flutter -Atrial fibrillation (AF) -Ventricular-premature beats (contractions) -Ventricular-tachycardia (VT) -Ventricular fibrillation (VF) Brady-cardiac arrhythmias -Bundle branch blocks -Sinus bradycardia (Sick Sinus Syndrome)

上游充通大 SHANGHAI JIAO TONG UNIVERSITY 1896 1920 1987 2006 Mechanisms of Arrhythmias 易 Disturbance of impulse formation Disturbance of impulse conduction ●both AO TONG UNI

Mechanisms of Arrhythmias Disturbance of impulse formation Disturbance of impulse conduction both

上浒充通大学 SHANGHAI JIAO TONG UNIVERSITY 1896 1920 1987 2006 Mechanisms of Arrhythmias Abnormal automaticity n SHANGHAI JIAO T、 INa/Ca ca() Ik Ica(T)

Mechanisms of Arrhythmias Abnormal automaticity