Editing Antiarrhythmic agent (section)

==Modernized Oxford classification by Lei, Huang, Wu, and Terrar==
[[File: Wikipedia_table_11_copy.jpg|thumb|class=skin-invert-image|Common anti-arrhythmic drugs under the modernized classification according to Lei et al. 2018]]
A recent publication (2018) has now emerged with a fully modernised drug classification.<ref>{{cite journal |last1=Lei |first1=Ming |last2=Wu |first2=Lin |last3=Terrar |first3=Derek A. |last4=Huang |first4=Christopher L.-H. |title=Modernized Classification of Cardiac Antiarrhythmic Drugs |journal=Circulation |date=23 October 2018 |volume=138 |issue=17 |pages=1879–1896 |doi=10.1161/CIRCULATIONAHA.118.035455|pmid=30354657 |doi-access=free }}</ref> This preserves the simplicity of the original Vaughan Williams framework while capturing subsequent discoveries of sarcolemmal, sarcoplasmic reticular and cytosolic biomolecules. The result is an expanded but pragmatic classification that encompasses approved and potential anti-arrhythmic drugs. This will aid our understanding and clinical management of cardiac arrhythmias and facilitate future therapeutic developments. It starts by considering the range of pharmacological targets, and tracks these to their particular cellular electrophysiological effects. It retains but expands the original Vaughan Williams classes I to IV, respectively covering actions on Na+ current components, autonomic signalling, K<sup>+</sup> channel subspecies, and molecular targets related to [[Calcium metabolism#Intracellular signalling|Ca<sup>2+</sup> homeostasis]]. It now introduces new classes incorporating additional targets, including:
*Class 0: ion channels involved in automaticity
*Class V: mechanically sensitive ion channels
*Class VI: connexins controlling electrotonic cell coupling
*Class VII: molecules underlying longer term signalling processes affecting structural remodeling.
It also allows for multiple drug targets/actions and adverse pro-arrhythmic effects. The new scheme will additionally aid development of novel drugs under development and is illustrated here.