Conventional Antiarrhythmics Class I-IV, Late INa Inhibitors, IKs Enhancers, RyR2 Stabilizers, Gap Junction Modulators, Atrial-Selective Antiarrhythmics, and Stable Gastric Pentadecapeptide BPC 157 as Useful Cytoprotective Therapy in Arrhythmias.

Review examining cytoprotection as a conceptual therapeutic criterion for antiarrhythmic drugs, focusing on BPC 157.

“This review examines and hypothesizes cytoprotection as a conceptual therapeutic criterion for antiarrhythmic drugs, referring to the possibility of suppressing arrhythmias while avoiding adverse electrophysiological or systemic effects.”

Rodent models and HEK293 cells for preclinical data; human trials limited to non-cardiac conditions.

“Still predominantly in preclinical models, stable gastric pentadecapeptide BPC 157, in the clinic, has not demonstrated adverse effects in available human trials (non-cardiac) to date.”

BPC 157 demonstrates cytoprotective antiarrhythmic effects in preclinical models, restoring sinus rhythm and normalizing intervals across various arrhythmogenic triggers.

“BPC 157 restores sinus rhythm, normalizes P/QRS/QT intervals, prevents AV block, suppresses VT, attenuates ST-segment changes, and stabilizes heart rate, even when insults are advanced.”

In vitro studies show BPC 157 stabilizes membrane potential by preventing hypokalemia-induced hyperpolarization and reducing hyperkalemia-induced depolarization.

“BPC 157 prevents hypokalemia-induced hyperpolarization, reduces hyperkalemia- and hypermagnesemia-induced depolarization, and mitigates local anesthetic-induced Na+/Ca2+ dysregulation, reflecting bidirectional homeostatic modulation of membrane potential.”

Human cardiac electrophysiology data are not yet available, and the concept may oversimplify the multifaceted nature of cardiac arrhythmias.

“Human cardiac electrophysiology data are not yet available.”