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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. Amiodarone was the first agent described in this class. [4]
Amiodarone has mostly Class III activity, but also I, II, & IV activity [6] 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
Budiodarone (ATI-2042) is an antiarrhythmic agent and chemical analog of amiodarone that is currently being studied in clinical trials.Amiodarone is considered the most effective antiarrhythmic drug available, [1] [2] [3] but its adverse side effects, including hepatic, pulmonary and thyroid toxicity as well as multiple drug interactions, [4] are discouraging its use.
Atrial fibrillation is associated with an increased risk of heart failure, dementia, and stroke. [3] [12] It is a type of supraventricular tachycardia. [14] Atrial fibrillation frequently results from bursts of tachycardia that originate in muscle bundles extending from the atrium to the pulmonary veins. [15]
Cardiac cells have two refractory periods, the first from the beginning of phase 0 until part way through phase 3; this is known as the absolute refractory period during which it is impossible for the cell to produce another action potential. This is immediately followed, until the end of phase 3, by a relative refractory period, during which a ...
Amiodarone in atrial fibrillation with WPW, is linked to ventricular fibrillation, and thus may be worse than procainamide. [ 7 ] AV node blockers should be avoided in atrial fibrillation and atrial flutter with WPW or history of it; this includes adenosine , diltiazem , verapamil , other calcium channel blockers , and beta blockers . [ 25 ]
Synchronized electrical cardioversion is used to treat hemodynamically unstable supraventricular (or narrow complex) tachycardias, including atrial fibrillation and atrial flutter. It is also used in the emergent treatment of wide complex tachycardias, including ventricular tachycardia, when a pulse is present.
While procainamide and quinidine may be used in the conversion of atrial fibrillation to normal sinus rhythm, they should only be used in conjunction with an AV node blocking agent such as digoxin or verapamil, or a beta blocker, because procainamide and quinidine can increase the conduction through the AV node and may cause 1:1 conduction of ...