Rationale of combination antiarrhythmic drug therapy.

In summary, antiarrhythmic combinations have been explored as a matter of clinical necessity in many instances, and clinical circumstance has led to attempted combination therapy with two, and sometimes more, drugs. Few controlled studies using a specific combination have been performed. Therapy is thus usually empiric, based on available clinical, electrophysiologic and pharmacologic information. Nonetheless, certain general impressions are available, which may form the basis for clinical decisions and for structuring future trials (Table 6). Although single-drug antiarrhythmic therapy continues to be advisable, in certain instances combined-drug therapy may be appropriate and efficacious. The importance of potential adverse drug interactions must also be appreciated.