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Prevent paroxysmal atrial fibrillation [7] and haemodynamically stable ventricular tachycardia [8] (amiodarone) Treat atrial flutter and atrial fibrillation (ibutilide) Treat ventricular tachycardia and atrial fibrillation (sotalol) Treat Wolff-Parkinson-White syndrome; IV Calcium channel blockers Diltiazem; Verapamil; Ca 2+ channel blocker
In a later atrial fibrillation trial, ATHENA, with 4628 subjects, dronedarone was significantly more effective than placebo in reducing the composite endpoint of first hospitalization due to cardiovascular events or death. [17] There was a significant reduction in the rate of cardiovascular death, but not in the rate of death from any cause. [5]
This causes the refractory period of atrial tissue to increase, hence its effectiveness in the treatment of atrial fibrillation and atrial flutter. Dofetilide does not affect dV/dT max (the slope of the upstroke of phase 0 depolarization), conduction velocity, or the resting membrane potential. Dofetilide synthesis
Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of cardiac dysrhythmias. [4] This includes ventricular tachycardia, ventricular fibrillation, and wide complex tachycardia, atrial fibrillation, and paroxysmal supraventricular tachycardia. [4]
For selected patients, a trial of oral disopyramide is a reasonable approach before proceeding to invasive septal reduction. Patients who respond to disopyramide are continued on the drug. Those who continue to have disabling symptoms or who experience side effects are promptly referred for septal reduction.
The negative chronotropic effects of CCBs make them a commonly used class of agents in individuals with atrial fibrillation or flutter in whom control of the heart rate is generally a goal. Negative chronotropy can be beneficial when treating a variety of disease processes because lower heart rates represent lower cardiac oxygen requirements.
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