Frontal plane QRS‐T angle in the monitoring of intravenous amiodarone infusion for pharmacological cardioversion of acute atrial fibrillation

2020 ◽  
Author(s):  
Mehmet Eyuboglu
Keyword(s):  
Atrial Fibrillation ◽  
Frontal Plane ◽  
Intravenous Amiodarone ◽  
Pharmacological Cardioversion

scholarly journals Pharmacological Cardioversion of Atrial Fibrillation In Nepalese Population

2004 ◽  
Vol 3 (3) ◽  
pp. 42-43
Author(s):  
Bharat Rawat ◽  
D.B Karki ◽  
SC Jha ◽  
Jesson Gurung ◽  
Subhash Acharya ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Hypertensive Patients ◽  
Intravenous Amiodarone ◽  
Pharmacological Cardioversion

Intravenous Procainamide and Oral Flecainide are often used for cardioversion of Paroxysmal Atrial Fibrillation (AF). Hypertensive patients may have problems ofproarrythmias with these agents and Intravenous Amiodarone may be an effective safer alternative. The utility of Intravenous Amiodarone in such group of patients in the Himalayan kingdom of Nepal has never been assessed.

scholarly journals Anticoagulation in Atrial Fibrillation Cardioversion: What Is Crucial to Take into Account

2021 ◽  
Vol 10 (15) ◽  
pp. 3212
Author(s):  
Fabiana Lucà ◽  
Simona Giubilato ◽  
Stefania Angela Di Fusco ◽  
Laura Piccioni ◽  
Carmelo Massimiliano Rao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Thrombus Formation ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Significant Advance ◽  
Thromboembolic Events ◽  
Thromboembolic Risk ◽  
Pharmacological Cardioversion

The therapeutic dilemma between rhythm and rate control in the management of atrial fibrillation (AF) is still unresolved and electrical or pharmacological cardioversion (CV) frequently represents a useful strategy. The most recent guidelines recommend anticoagulation according to individual thromboembolic risk. Vitamin K antagonists (VKAs) have been routinely used to prevent thromboembolic events. Non-vitamin K antagonist oral anticoagulants (NOACs) represent a significant advance due to their more predictable therapeutic effect and more favorable hemorrhagic risk profile. In hemodynamically unstable patients, an emergency electrical cardioversion (ECV) must be performed. In this situation, intravenous heparin or low molecular weight heparin (LMWH) should be administered before CV. In patients with AF occurring within less than 48 h, synchronized direct ECV should be the elective procedure, as it restores sinus rhythm quicker and more successfully than pharmacological cardioversion (PCV) and is associated with shorter length of hospitalization. Patients with acute onset AF were traditionally considered at lower risk of thromboembolic events due to the shorter time for atrial thrombus formation. In patients with hemodynamic stability and AF for more than 48 h, an ECV should be planned after at least 3 weeks of anticoagulation therapy. Alternatively, transesophageal echocardiography (TEE) to rule out left atrial appendage thrombus (LAAT) should be performed, followed by ECV and anticoagulation for at least 4 weeks. Theoretically, the standardized use of TEE before CV allows a better stratification of thromboembolic risk, although data available to date are not univocal.

scholarly journals Optimal Anticoagulation Strategy for Cardioversion in Atrial Fibrillation

2015 ◽  
Vol 4 (1) ◽  
pp. 44 ◽  
Author(s):  
Philipp Bushoven ◽  
Sven Linzbach ◽  
Mate Vamos ◽  
Stefan H Hohnloser ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Stroke Prevention ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Prospective Trial ◽  
Bleeding Complications ◽  
Order Of Magnitude ◽  
Pharmacological Cardioversion

For many patients with symptomatic atrial fibrillation, cardioversion is performed to restore sinus rhythm and relieve symptoms. Cardioversion carries a distinct risk for thromboembolism which has been described to be in the order of magnitude of 1 to 3 %. For almost five decades, vitamin K antagonist therapy has been the mainstay of therapy to prevent thromboembolism around the time of cardioversion although not a single prospective trial has formally established its efficacy and safety. Currently, three new direct oral anticoagulants are approved for stroke prevention in patients with non-valvular atrial fibrillation. For all three, there are data regarding its usefulness during the time of electrical or pharmacological cardioversion. Due to the ease of handling, their efficacy regarding stroke prevention, and their safety with respect to bleeding complications, the new direct oral anticoagulants are endorsed as the preferred therapy over vitamin K antagonists for stroke prevention in non-valvular atrial fibrillation including the clinical setting of elective cardioversion.

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.

scholarly journals MEDICATION FOR PHARMACOLOGICAL CARDIOVERSION OF PAROXYSMAL ATRIAL FIBRILLATION AT THE PREHOSPITAL STAGE: STUDY OF EFFICACY AND SAFETY

2018 ◽  
Vol 18 (4) ◽  
pp. 43-47
Author(s):  
I. Y. Lukianova ◽  
A. V. Kuzneztov ◽  
V. M. Komarnitzkii ◽  
A. G. Kozyreva
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Efficacy And Safety ◽  
Pharmacological Cardioversion

This study demonstrates the effectiveness of procainamide, propafenone and amiodaronefor pharmacological cardioversion in patients with paroxysmal atrial fibrillation. The restoration of the sinus rhythm within 60 minutes was observed for propafenone 73,2%, for procainamide 55,00% and for amiodarone 16,13% of cases.

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