Possible Interaction: Anti-Arrhythmia Agents and Potassium

“Recently, it has been suggested that combining potassium and calcium channel blocking mechanisms reduces the proarrhythmic potential of selective class III antiarrhythmic agents.”

“Accompanying these antiarrhythmic actions , quinidine, procaine amide (Pronestyl), propranolol (Inderal), and potassium worsen atrioventricular block; whereas lidocaine (Xylocaine) usually does not influence nodal conduction velocity, and diphenylhydantoin accelerates this property in the atrioventricular node.”

“Quite a similar antagonism was demonstrated between low potassium concentration and other antiarrhythmic agents (antazoline and SU-11636), while high potassium concentration (12 mEq./L.) enhanced the depressive effects of these three drugs.”

“Although antiarrhythmic agents or deep sedation were not effective for the VF, an intravenous supplementation of potassium completely suppressed the VF with a reduction in the J‐wave amplitude.”

“By blocking potassium outflow currents, the anti-arrhythmic drugs prolong the action potential.”

“ Antiarrhythmic drugs class IA (quinidine, disopyramide), class III (sotalol, amiodarone), class IV (… blockers) used at the same time with potassium depleters diuretics or beta-blocking agents result in the inhibition of repolarization and the increased … activation potential with the risk of developing arrhythmia of the torsade de pointes types.”

“ Antiarrhythmic agents act by blocking the membrane sodium, potassium , and calcium channels, but no agent has exclusive action on a given type of channel.”

“In addition, the presence of potassium in adequate amounts is required for the effective action of many antiarrhythmic agents.”

“Even newly released anti-arrhythmic drugs , like ivabradine with HCN channel as a primary target, block the hERG potassium current in overlapping concentration interval.”

“The significant anti-arrhythmia action can be achieved by inhibiting ionic channels of sodium, potassium , calcium, etc.,”