A Fib Flashcards
What is first line treatment for Atrio-ventricular re-entrant tachycardia and atrial flutter?
Cathetar ablation
Name 2 class IC anti-arrhymics
Flecainide and propafenone
Class IC antiarrhythmics is CI in?
patients with CAD. Preferred in patients with just hypertension or no other CV risk factors.
Dronedarone place in therapy
Preferred treatment in patients with CAD except patients with heart failure.
Amiodarone SE
1) Neurological: gait abnormalities, dizziness, peripheral neuropathy.
2) Lung fibrosis
3) Hyper/hypo thyroidism
4) Liver problems
5) Eye issues (i.e. visual disturbances or corneal deposits.
6) GI
7) CVS: hypotension, bradycardia
8) Derm: photosensitivity, blue skin
Dronedarone SE and Int
1) headache
2) GI
3) asthenia (muscle weakness)
4) liver.
- Also increases digoxin and statin level.
Amiodarone Int
Is an inhibitor of many enzymes so increased levels of 1) digoxin,
2) warfarin,
3) statins,
4) procainamide,
5) quinidine.
Name 4 Class III antiarrhythmics
1) Dronedarone
2) Amiodarone
3) Sotalol
4) Dofetilide.
Special considerations of IC drugs?
1) Has to be prescribed with AV nodal blocking agent such as BB or CCB
When choose rate control v.s. rhythm control
Choose rhythm if:
1) patient with more than minimal symptoms
2) patient is young and asymptomatic
3) Has cardiac hypertrophy
Rate control therapeutics
First line is BB or CCB (i.e. diltiazem or verapamil).
2nd line: digoxin
3rd line: dronedarone/ amiodarone.
If patient post MI or HF, don’t use CCB, just use BB or digoxin.
Rhythm control therapeutics
1) Patients with minimal CAD, can use IC or III
2) Patients with CAD: class III
3) Patients with HF: use amiodarone (<35% LVF)
Target Rate control
Resting HR<100 bpm
Digoxin SE
1) GI
2) Visual changes (greenish objects)
3) Neurological: confusion, delirium, dizziness
4) CV: could cause arrhythmias
Digoxin MOA
- Increases cardiac output
- decreases heart rate.
