Experimental search for drugs for the treatment of atrial fibrillation (literature review)

Atrial fibrillation is the most common cardiac arrhythmia with frequent complications. Despite a century of research and speculation, the mechanisms underlying AF have not been fully elucidated, and therapy, especially for the permanent form, remains suboptimal. The use of modern antiarrhythmic drugs is associated with a significant level of side effects, especially proarrhythmic ones. Many patients with severe atrial fibrillation symptoms do not receive any therapy for rhythm control. In this review, the main focus will be on pharmacological developments in the treatment of atrial fibrillation. We will discuss the current status of some antiarrhythmic drugs and their future potential in the treatment of atrial fibrillation, reviewing the molecular mechanisms and clinical use of some atrial-selective antifibrillatory drugs. We will review in detail the key pharmacodynamic and pharmacokinetic properties of these drugs in order to prevent proarrhythmic effects. As well as drugs that affect atrial remodeling, inflammation and fibrosis, which are being tested as potential treatments for atrial fibrillation.