Optimal management with Class I and Class III antiarrhythmic drugs should be done in the outpatient setting: protagonist...presented at 'Optimal Management of Atrial Fibrillation: a Case Study Approach' symposium, November 7, 1998, Dallas, TX
It has been suggested that patients be admitted for the initiation of Class I and Class III antiarrhythmic drugs to avoid serious proarrhythmic consequences. The most clinically significant proarrhythmic response to Class IC agents is likely due to an interaction with acute ischemia, and hospitaliza...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 10; no. 3; pp. 472 - 489 |
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| Autores principales: | , |
| Formato: | CEU exam questions Journal Article |
| Publicado: |
Wiley-Blackwell
Mar1999
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107225115&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107225115 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Mar1999 vid: 10 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 107225115 1999073932 10.1111/j.1540-8167.1999.tb00701.x NLM10210515 107225115 ppf: 472 ppct: 17 formats: fmt: @attributes: type: P tig: atl: Optimal management with Class I and Class III antiarrhythmic drugs should be done in the outpatient setting: protagonist...presented at 'Optimal Management of Atrial Fibrillation: a Case Study Approach' symposium, November 7, 1998, Dallas, TX aug: au: Thibault B Nattel S affil: Department of Medicine, University of Montreal, Quebec, Canada sug: subj: Arrhythmia Drug Therapy Antiarrhythmia Agents Therapeutic Use Outpatients Hospitalization Antiarrhythmia Agents Adverse Effects Heart Rate Drug Effects Arrhythmia Physiopathology Arrhythmia Economics Education, Continuing (Credit) ab: It has been suggested that patients be admitted for the initiation of Class I and Class III antiarrhythmic drugs to avoid serious proarrhythmic consequences. The most clinically significant proarrhythmic response to Class IC agents is likely due to an interaction with acute ischemia, and hospitalization for initiation of drug therapy has little predictive or preventive value. Amiodarone has a low risk of proarrhythmia, and any proarrhythmic reactions are generally delayed. Class IA and Class III antiarrhythmic drugs cause acquired long QT syndrome arrhythmias, which can occur soon after initiation of therapy; however, only about half of the arrhythmic events occur within 3 days of initiation of therapy. It could be argued that all patients should be hospitalized to begin Class IA or Class III drugs; however, this approach has a low yield and is extremely expensive. An alternative is to use Class IA and Class III drugs for patients at low risk of torsades de pointes (e.g., males without heart failure, ventricular tachyarrhythmias, or active coronary disease), in whom hospitalization for drug initiation is not warranted. Higher risk patients are probably better treated with other agents, such as Class IC drugs or amiodarone for women without organic heart disease and amiodarone for patients with heart failure, a history of ventricular tachycardia, or active coronary disease. When a Class IA or Class III drug is required for patient with an increased risk of torsades de pointes, hospital admission for drug initiation may be indicated. pubtype: Academic Journal doctype: CEU exam questions Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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