Figure 2. Paradigm shift in antiarrhythmic drug (AAD) therapy.

Most of the currently available AADs were coincidental findings, affect numerous electrophysiological targets and are applied to a heterogeneous group of patients in a ‘one-size-fits-most approach’ (left panel), resulting in limited efficacy and substantial adverse effects including proarrhythmia and extracardiac toxicity. Future ‘precision medicine’ approaches will likely provide a tailored, mechanism-based therapy by a deliberate combination of a number of selective AADs based on individual arrhythmia mechanisms (right panel).