Экспериментальные поиски препаратов для лечения фибрилляции предсердий (литературный обзор)

Фибрилляция предсердий или мерцательная аритмия является самым распространённым нарушением ритма сердца с частыми осложнениями. Несмотря на столетие исследования и предположения, механизмы, лежащие в основе фибрилляции предсердий, так и не были до конца установлены, а терапия, особенно постоянной формы, остаётся неоптимальной. Назначение современных антиаритмических препаратов связано со значительным уровнем побочных эффектов, особенно проаритмическими. Многие пациенты с выраженной симптоматикой фибрилляции предсердий не получают терапии для контроля ритма. В этом обзоре основное внимание уделено фармакологическим разработкам в лечении фибрилляции предсердий. Проанализирован нынешний статус некоторых антиаритмических препаратов и их дальнейшая возможность в терапии ФП, рассмотрены молекулярные механизмы и клиническое использование некоторых селективных для предсердий антифибрилляторных препаратов. Подробно описаны ключевые фармакодинамические и фармакокинетические свойства этих препаратов с целью предупреждения проаритмических эффектов, а также препаратов, влияющих на ремоделирование предсердий, воспаление и фиброз, которые проходят тестирования в качестве потенциальных методов лечения фибрилляции предсердий.

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