Together they have now published a comprehensive modern classification, based upon the original version, in the leading journal ‘Circulation’.
Findings over the past 5 decades from studies of different molecular drug targets, their mechanisms of action, and consequent clinical effects have led to the need to revise the classification. The modernised Oxford classification augments Vaughan Williams’s original framework covering the actions of sodium, potassium and calcium ions and the effects on these of the nervous system (Class I-IV). Novel categories now relate to altered heart rates (Class 0), mechanical stretch (Class V); intercellular electrical communication (Class IV) and longer term structural change (Class VII). The scheme then draws attention to multiple drug targets and actions and possible adverse, even pro-arrhythmic, effects.
This clarified classification of both the actions and therapeutic applications of both established drugs and novel drugs under investigation will improve current and future treatment of cardiac arrhythmias. It will encourage a rational clinical use of existing available anti-arrhythmic drugs in relationship to their particular mechanisms of action. It will aid identification and development of novel drugs relating their future clinical applications to their molecular mechanisms of action.
The classification commemorates and advances the landmark contributions of Miles Vaughan Williams (https://en.wikipedia.org/wiki/Miles_Vaughan_Williams) to the physiology of the heart that began this quest nearly half a century ago on this centenary of his birth. It is likely that the new classification will have an enduring impact on cardiological medicine.
See the text of the paper here:
https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.118.035455
https://www.ahajournals.org/doi/suppl/10.1161/circulationaha.118.035455.