Pharmacological Treatment of Atrial Fibrillation: Mechanisms of Action and Efficacy of Class III Drugs

2006 ◽  
Vol 13 (14) ◽  
pp. 1635-1653 ◽  
Author(s):  
Federico Lombardi ◽  
Paolo Terranova
Keyword(s):  
Atrial Fibrillation ◽  
Pharmacological Treatment ◽  
Mechanisms Of Action ◽  
Class Iii

Effect of amiodarone on heart rate variability in patients with newly diagnosed atrial fibrillation (clinical observation)

2020 ◽  
pp. 81-85
Author(s):  
E. P. Popova ◽  
O. T. Bogova ◽  
S. N. Puzin ◽  
D. A. Sychyov ◽  
V. P. Fisenko
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Drug Therapy ◽  
Heart Function ◽  
Newly Diagnosed ◽  
Class Iii ◽  
Spectral Parameters ◽  
Patient Will ◽  
The Individual

Spectral analysis of heart rate variability gives an idea of the role of the autonomic nervous system in the regulation of chronotropic heart function. This method can be used to evaluate the effectiveness of drug therapy. Drug therapy should be carried out taking into account the individual clinical form of atrial fibrillation. Information about the vegetative status of the patient will undoubtedly increase the effectiveness of treatment. In this study, spectral parameters were studied in patients with newly diagnosed atrial fibrillation. The effect of antiarrhythmic drug class III amiodarone on the spectral parameters of heart rate variability was studied.

Hypersensitivity Reaction to Amiodarone in a Patient with a Previous Reaction to an lodinated Radiocontrast Agent

2007 ◽  
Vol 41 (7-8) ◽  
pp. 1310-1314 ◽  
Author(s):  
Leanne Stafford
Keyword(s):  
Atrial Fibrillation ◽  
Hypersensitivity Reaction ◽  
Product Information ◽  
Artery Bypass ◽  
Amiodarone Therapy ◽  
Class Iii ◽  
Radiocontrast Agent ◽  
Triple Vessel Disease ◽  
Intravenous Amiodarone ◽  
Previous Reaction

Objective: To describe a case of a hypersensitivity reaction to oral amiodarone in a patient with a previous reaction to an iodinated radiocontrast agent. Case Summary: A 55-year-old man experienced facial urticaria after intraarterial injection of iohexol, an iodinated radiocontrast agent, during coronary angiography, which was successfully treated with intravenous hydrocortisone and promethazine. The procedure revealed significant triple vessel disease, and the patient subsequently underwent coronary artery bypass grafting in October 2006. Postoperatively, the patient experienced 2 episodes of fast atrial fibrillation, the first of which was treated successfully with intravenous amiodarone. The second episode resulted in the commencement of therapy with oral amiodarone 400 mg 3 times daily. Within one hour after the first dose, the patient experienced tip swelling and tingling, which was again treated with intravenous promethazine. Amiodarone was stopped; the patient remained in sinus rhythm and was discharged without further incident. Discussion: Amiodarone is a class III antiarrhythmic agent frequently used in the management of atrial fibrillation after cardiac surgery. The approved product information lists known hypersensitivity to iodine as a contraindication to its administration, but no other cases of amiodarone hypersensitivity in a patient with a previous reaction to an iodinated radiocontrast agent have been published, Conversely, it has been suggested that the drug may be safely used in such patients. The Naranjo probability scale supported a probable adverse reaction of hypersensitivity associated with amiodarone therapy in this patient. Conclusions: Prescribers should exercise caution in the administration of amiodarone to patients with a true, documented history of hypersensitivity to an iodinated compound.

Abstract 038: A Novel Histology Based Classification System to Identify Patients at Risk for Postoperative Atrial Fibrillation

2013 ◽  
Vol 113 (suppl_1) ◽  
Author(s):  
Mahek Mirza ◽  
Anton Strunets ◽  
Ekhson Holmuhamedov ◽  
Jasbir Sra ◽  
Paul H Werner ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
At Risk ◽  
Classification System ◽  
Area Under The Curve ◽  
Postoperative Atrial Fibrillation ◽  
Right Atrial ◽  
Class Iii ◽  
Atrial Fibrosis ◽  
Patients At Risk ◽  
The Impact

Postoperative atrial fibrillation (PoAF) is a common complication in up to 40% of patients after cardiac surgery, increasing morbidity, hospital stay and costs. The myocardial substrate underlying PoAF is not fully characterized. The objective was to assess the impact of atrial fibrosis on incident AF and define the fibrosis threshold level predictive of PoAF. Methods: Right atrial appendages removed from patients undergoing elective CABG with no history of AF or class III/IV heart failure were used to characterize the ratio of collagen to myocardium (Masson’s trichrome; NIH ImageJ software; Fig A), which was correlated with incident AF. Percentage burden of fibrosis predictive of PoAF with high sensitivity and specificity was determined by ROC curve. Results: Of 28 patients (67±10 years, 64% males), 15 had PoAF. There were no age, gender or comorbidity differences between groups. Compared to the group that remained in sinus rhythm, patients with PoAF had a significantly higher ratio of extracellular collagen to myocardium (45±16% vs. 5±4%, p <0.001; Fig B). A threshold ratio of 12.7% collagen to myocardium (ROC area under the curve 0.997; z statistic 137; P<0.0001) with 96% sensitivity and 97% specificity identified those with PoAF (Fig C). A classification system based on histological extent of atrial fibrosis is proposed for identifying patients at risk for PoAF (Fig D). Conclusion: Ongoing studies will confirm the predictive value of this new classification system for identifying the atrial substrate predisposing PoAF and correlate with preoperative cardiac imaging and circulatory serum biomarkers to provide a novel noninvasive tool to stratify patients at risk for PoAF.

Inhibition of IK,ACh current may contribute to clinical efficacy of class I and class III antiarrhythmic drugs in patients with atrial fibrillation

2009 ◽  
Vol 381 (3) ◽  
pp. 251-259 ◽  
Author(s):  
Niels Voigt ◽  
Nadiia Rozmaritsa ◽  
Anne Trausch ◽  
Thomasz Zimniak ◽  
Torsten Christ ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Efficacy ◽  
Antiarrhythmic Drugs ◽  
Class I ◽  
Class Iii

553 Efficiency of new class III antiarrhythmic — Nibentan versus amiodarone for sinus rhythm restoration in paroxysmal atrial fibrillation patients

EP Europace ◽  
2005 ◽  
Vol 7 (Supplement_1) ◽  
pp. 121-121
Author(s):  
A. Ardashev ◽  
M. Kruchko ◽  
O. Vrublevskiy ◽  
A. Shavarov ◽  
M. Chernov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Class Iii ◽  
New Class

scholarly journals Safety and Effectiveness of Electrical and Pharmacological Cardioversion in Persistent Atrial Fibrillation. Part 2: Assessment of Safety

2019 ◽  
Vol 14 (6) ◽  
pp. 826-830
Author(s):  
N. Yu. Mironov ◽  
V. V. Vlodzyanovskiy ◽  
Yu. A. Yuricheva ◽  
S. F. Sokolov ◽  
S. P. Golitsyn ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Qt Interval ◽  
Persistent Atrial Fibrillation ◽  
Initial Assessment ◽  
Class Iii ◽  
Qt Interval Prolongation ◽  
Direct Current Cardioversion ◽  
Group 2 ◽  
Pharmacological Cardioversion ◽  
Ischemic Attack

Aim. To compare safety of new class III antiarrhythmic drug Refralon with direct current cardioversion (DCC) in patients with persistent atrial fibrillation (AF). Material and methods. 60 patients with persistent AF were randomized to groups of DCC (n=30) and pharmacologic conversion (PCV; n=30). There were no significant differences in age, sex, AF duration, concomitant cardiovascular diseases, CHA2DS2-VASc score and echocardiographic parameters between the groups compared. Initial assessment excluded contraindications to restore sinus rhythm (SR). In DCC group two attempts using biphasic synchronized shocks of 150 J and 170 J were performed. In PCV group patients received up to three subsequent intravenous injections of Refralon 10 μg/kg (maximal dose 30 μg/kg). Results. There were no mortality, stroke, transient ischemic attack, ventricular arrhythmia, asystole longer than 3,0 sec (primary safety criteria) in both groups. Prolongation of QT interval longer than 500 ms observed in 1 of 30 patients (3,3%) in DCC group and in 7 of 30 patients (23,3%) in PCV group. 2 patients (one patient in each group; 3,3%) developed asymptomatic bradycardia after conversion to SR that resolved spontaneously within 30 minutes. 95% confidence interval (95%CI) for secondary safety criteria is [0,02-0,38] for QT prolongation and [-0,04-0,04] for bradycardia. Conclusion. Safety of PCV is noninferior to DCC in patients with persistent AF in terms of primary safety criteria and bradyarrhythmias. More frequent QT interval prolongation to values >500 ms observed in PCV group points to necessity of precautions with use of the drug.

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