In the latest episode of Arrhythmia Academy’s Journal Club, Prof Serge Boveda (Clinic Pasteur, Toulouse, FR) is joined by Prof José Luis Merino (La Paz University Hospital, Madrid, ES) to discuss the EHRA Practical Compendium on Anti-Arrhythmic Drugs (AADs) and its relevance to everyday electrophysiology practice.

The discussion highlights why AADs remain central to arrhythmia management despite advances in catheter ablation, citing low ablation penetration rates, ongoing post-ablation drug use, and the continued need for medical therapy across a broad patient population. Prof Merino introduces the compendium’s “ABC” framework, categorising AAD use as Appropriate, Backup or Complementary, to support pragmatic clinical decision-making.

Key updates to the Vaughan Williams classification are reviewed, including the introduction of Class 0 agents, the new Class 1D category for ranolazine, and expanded definitions within Class 2 drugs. The speakers also outline a simplified three-step approach to AAD selection, focusing on electrophysiological targets, structural heart disease and heart failure status.

The episode concludes with insights into safety considerations, emerging drug delivery strategies, and practical guidance for managing ventricular arrhythmias, reinforcing the compendium’s role as a concise, clinically focused reference for modern EP practice.

Recorded remotely from Toulouse and Madrid, 2025.