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Pilsicainide is a class 1c antiarrhythmic agent used primarily in Japan for the management of cardiac arrhythmias, especially atrial tachyarrhythmias and paroxysmal atrial fibrillation. It acts as a pure sodium channel blocker, specifically inhibiting the fast inward movement of sodium ions through the Nav1.5 sodium channel during phase 0 of the cardiac action potential. This results in suppression of abnormal cardiac excitation and control of irregular pulse without significant effects on potassium or calcium channels. Pilsicainide was developed by Suntory Holdings Limited and first released in 1991[4][6][3][1].
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