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For conversion of AF of 7 days or less, agents with proven efficacy include dofetilide, flecainide, ibutilide, propafenone, and, to a lesser degree, amiodarone and quinidine; less effective or incompletely studied agents include procainamide, digoxin, and sotalol.
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Another form of this medicine, called Betapace (sotalol), is used to treat heart rhythm disorders of the (the lower chambers of the heart that allow blood to flow out of the heart).
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Exercise and isoproterenol induced tachycardia are antagonized by Sotalol and total peripheral resistance increases by a small amount.
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QRS pattern with negative concordance in the precordial leads is diagnostic for VT (“negative concordance” means that the QRS patterns in all of the precordial leads are similar, and with QS complexes).
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The risk of amiodarone-induced liver, lung, thyroid, and other toxicities has prompted publication of specific follow-up testing guidelines.
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The Class III electrophysiological effects in man include prolongation of the atrial and ventricular monophasic action potentials, and effective refractory period prolongation of atrial muscle, ventricular muscle, and atrioventricular accessory pathways (where present) in both the anterograde and retrograde directions.
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In conclusion, among patients with ischemic cardiomyopathy who had recurrent ventricular tachycardia and an ICD despite first-line AAD therapy, the rate of the composite outcome of death at any time or ventricular tachycardia storm or appropriate ICD shock after 30 days was lower than that among patients who received escalated AAD therapy.
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In these cases, symptoms mimicking “pacemaker syndrome” may occur due to retrograde conduction from the AV junction to the atrium and resultant atrial contraction against closed atrioventricular valves, resulting in cannon A waves and possible hypotension.
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In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with sotalol.
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The dosage interval should be increased to 36 to 48 hours.
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Digoxin does not control rate effectively during exercise and should be used as first line therapy only in people who are sedentary, or in overt heart failure.
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When a patient notes that there are side effects of Betapace, the doctor should be informed immediately.
The evidence base for this guideline was synthesised in accordance with Scottish Intercollegiate Guidelines Network (SIGN) methodology.
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HCPCS code J3490 is a non-specific code that should be used only when another 'J' code does not describe the drug being administered (i.
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