Antiarrhythmic drugs use in elderly patients. Vaughan Williams class III and IV drugs

The effectiveness of antiarrhythmic drugs in the elderly is similar to that in younger patients. However data for «the very elderly» are lacking. Elderly patients are more vulnerable to adverse drug reactions (ADRs) because of age-related changes of pharmacokinetics, co-morbidity and drug interactions. Amioadarone is not considered as the drug of choice in elderly patients because of the high risk of serious ADRs. Other class III drugs should be prescribed to the elderly with great caution under close monitoring of the treatment. Diltiazem and verapamil should not be used in elderly patients with NYHA class III-IV heart failure and should not be combined with β-blockers.