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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
Diltiazem, sold under the brand name Cardizem among others, is a nondihydropyridine calcium channel blocker medication used to treat high blood pressure, angina, and certain heart arrhythmias. [9] It may also be used in hyperthyroidism if beta blockers cannot be used. [ 9 ]
An FDA-approved medication already used to treat people who have type 2 diabetes and chronic kidney disease may also help lower their stroke and heart attack risk, a new study has found.
Verapamil is a class-IV antiarrhythmic and more effective than digoxin in controlling ventricular rate. [19] Verapamil is not listed as a first line antihypertensive agent by the guidelines provided by JAMA in JNC-8. [20] However, it may be used to treat hypertension if patient has co-morbid atrial fibrillation or other types of arrhythmia. [17 ...
Amiodarone is also safe to use in individuals with cardiomyopathy and atrial fibrillation, to maintain normal sinus rhythm. Amiodarone prolongation of the action potential is uniform over a wide range of heart rates, so this drug does not have reverse use-dependent action.
Fatty infiltration helps explain why obesity is a risk factor for atrial fibrillation in one fifth of patients. [63] Atrial fibrillation increases the risk of heart failure by 11 per 1000, kidney problems by 6 per 1000, death by 4 per 1000, stroke by 3 per 1000, and coronary heart disease by 1 per 1000. [162]
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.
Drugs like amiodarone, diltiazem, verapamil and metoprolol are frequently given before electrical cardioversion to decrease the heart rate, stabilize the patient and increase the chance that cardioversion is successful. There are various classes of agents that are most effective for pharmacological cardioversion.