Upon completion of the chapter the reader will be able to

1. Describe the phases of the cardiac action potential, compare and contrast the cellular ionic changes corresponding to each phase, and explain the relationship between the cardiac action potential and the ECG.

2. Describe the modified Vaughan Williams classification of antiarrhythmic drugs, and compare and contrast the effects of available antiarrhythmic drugs on ventricular conduction velocity, refractory period, automaticity, and inhibition of ion flux through specific myocardial ion channels.

3. Compare and contrast the risk factors for and the features, mechanisms, etiologies, symptoms, and goals of therapy of: (a) sinus bradycardia; (b) atrioventricular (AV) nodal blockade; (c) atrial fibrillation (AF); (d) paroxysmal supraventricular tachycardia (PSVT); (e) ventricular premature depolarizations (VPDs); (f) ventricular tachycardia (VT, including torsades de pointes); and (g) ventricular fibrillation (VF).

4. Compare and contrast appropriate nonpharmacologic and pharmacologic treatment options for sinus bradycardia and AV nodal blockade.

5. Compare and contrast the mechanisms of action of drugs used for ventricular rate control, conversion to sinus rhythm and maintenance of sinus rhythm in patients with AF, and explain the importance of anticoagulation for patients with AF.

6. Compare and contrast the mechanisms of action of drugs used for acute termination of PSVT.

7. Compare and contrast the role of drug therapy versus nonpharmacologic therapy for long-term prevention of recurrence of PSVT.

8. Describe the role of drug therapy for management of asymptomatic and symptomatic VPDs.

9. Compare and contrast the mechanisms of action of drugs used for the treatment of acute episodes of VT (including torsades de pointes), and describe options and indications for nonpharmacologic treatment of VT and VF.

10. Design individualized drug-therapy treatment plans for patients with: (a) sinus bradycardia; (b) AV nodal blockade; (c) AF; (d) PSVT; (e) VPDs; (f) VT (including torsades de pointes); and (g) VF.

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