Etripamil in Paroxysmal Supraventricular Tachycardia: A Physiological and Pharmacological Review and its Regulatory Considerations

Resumen

Etripamil is a novel, short-acting calcium channel blocker developed for the rapid management of paroxysmal supraventricular tachycardia (PSVT). This review summarizes its pharmacological properties, mechanism of action, pharmacokinetics, preclinical and clinical evidence, and safety profile. Etripamil selectively inhibits L-type calcium channels in the atrioventricular (AV) node, resulting in slowed conduction and effective termination of re-entrant tachycardias. Its intranasal formulation enables rapid absorption and self-administration, offering a significant advantage over conventional intravenous therapies. Clinical trials demonstrate favorable efficacy in converting PSVT to sinus rhythm with a manageable safety profile, including mild nasal and transient cardiovascular effects. Preclinical and translational studies support its physiological relevance and targeted action. Despite promising outcomes, further research is required to establish long-term safety and broader clinical applications. Overall, Etripamil represents an innovative, patient-centered approach to acute arrhythmia management.