Antiarrhythmics with propensity for proarrhythmic effects i

1
Anti-arrhythmics with propensity for
pro-arrhythmic effects (i)
" One should never give a drug such as
propafenone or flecainide in the absence of a
potent AV nodal blocker. Digitalis, in my
opinion, is not a potent AV nodal blocker for
most patients. Otherwise, the atrial rate can
slow to a flutter-like rhythm, often relatively
slow flutter with rates in the atrium of 200 to
240 bpm. In some patients this can result in a
11 AV conduction, and this can lead to a bizarre
wide QRS complex that would mimic ventricular
tachycardia." Eric N Prystowsky MD
2
Anti-arrhythmics with propensity for
pro-arrhythmic effects (ii)
"It is important to be sure there is no coronary
artery disease before using drugs such as
propafenone and flecainide in a population of
patients where coronary artery disease can be
expected to occur. " Eric N Prystowsky MD