New approaches to antiarrhythmic therapy; emerging therapeutic applications of the cell biology of cardiac arrhythmias.

Cardiac arrhythmias complicate many diseases affecting the heart and the circulation, and incorporate a multiplicity of underlying mechanisms. The evolution of scientific knowledge has made the complex changes produced by cardiovascular disease sufficiently understood at the organ, cellular, and molecular levels such that there is a diversity of therapeutic targets for pharmacological therapy and/or prevention. Moreover, the approach of rational drug design, in mechanism- and disease-specific fashion, facilitates targeting of therapy via molecular, structural and translational biology. Additional approaches, employing similar drug-design strategies but based on gene therapy and transcriptional and translational modification are on the horizon. Hence, there is reason to be optimistic regarding the design, testing and clinical availability of novel antiarrhythmic therapies.