Antiarrhythmic drugs are used to regulate heart rhythm, control heart rate, and prevent the recurrence of arrhythmias. They are classified into classes I-IV according to the Vaughan-Williams classification: Na+ channel blockers, beta-blockers, K+ channel blockers, and Ca2+ channel blockers. Treatment selection assesses the type of arrhythmia, causes, cardiac condition, drug interactions, and proarrhythmic risk. Dosage adjustment, ECG, electrolytes, and pharmacokinetic monitoring are essential. Acute and chronic strategies are differentiated