Modernized Classification of Cardiac Antiarrhythmic Drugs 2018

Q: Under Vaughan Williams classification of antiarrhythmic drugs (Revised 2018), statins have been classified under which class?

A) Class I

B) Class II

C) Class III

D) Class IV

E) Class VII

Answer: E

Under Revised (2018) Vaughan Williams classification of antiarrhythmic drugs, there are eight classes

• Class 0 (HCN channel blockers)
• Class I (voltage-gated Na+ channel blockers)
• Class II (autonomic inhibitors and activators)
• Class III (K+ channel blockers and openers)
• Class IV (Ca++ handling modulators)
• Class VII (upstream target modulators)

Class V (mechanosensitive channel blockers) and Class VI (gap junction channel blockers) have no authorized drugs. Both are still investigational classes.

Class VII i.e., upstream target modulators include Angiotensin-converting enzyme inhibitors, Angiotensin receptor blockers, Omega-3 fatty acids, and Statins

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Reference:

Lei M, Wu L, Terrar DA, Huang CL. Modernized Classification of Cardiac Antiarrhythmic Drugs. Circulation. 2018 Oct 23;138(17):1879-1896. doi: 10.1161/CIRCULATIONAHA.118.035455. Erratum in: Circulation. 2019 Mar 26;139(13):e635. PMID: 30354657.