ABSTRACT
European Society of Cardiology. It is known as the ‘Sicilian Gambit’—Sicilian after the location of the international meeting at which it was first published, and ‘Gambit’ after the Queen’s Gambit in chess representing an opening or potential way forward rather than a finished entity. Essentially, it seeks to classify antiarrhythmic drugs according to the molecular targets on which a drug acts (i.e. cell membrane ion channels and/or receptors), the mechanisms responsible for arrhythmogenesis that may respond to therapy, and relevant clinical considerations (Figure 20.9). The combination of mechanisms relevant to various drugs is clearly complex and it is not intended that trainees memorize them all. Figure 20.9 is included for reference and to give a more representative picture of reality than some of the simpler classifications described. In addition, the schematic structure of the Task Force classification is fluid and may change, but the receptors and ion channels that are involved as potential arrhythmogenic mechanisms are important. For convenience, however, the descriptive pharmacology of the antiarrhythmics is dealt with below with drugs grouped according to the classic Vaughan-Williams classification.
