Propafenone (Rythmonorm) was administered intravenously at a dose of 5mg/kg/3h to treat an atrial fibrillation case. Synal rhythm was restored in 2.30 hours with a QRS complex enlargement. 3 hours later on, a blood pressure drop as well as a cerebral and myocardial ischemia lasting 2 days were noted and were managed effectively with isoproterenol and dopamine. These drugs administered orally in divided doses up to 450 mg/day can put an end to the atrial fibrillation paroxysm while the maintenance dose of 450mg/day in fractional doses can prevent atrial fibrillation recurrence
Anti-Arrhythmia Agents ; Propafenone ; Overdose ; Accidents

BACKGROUND/AIMS: Long-term antiarrhythmic drug therapy remains the principal approach for suppressing atrial fibrillation (AF) and maintaining sinus rhythm. In this study, we examined the differing electrophysiological effects of various antiarrhythmic drugs on the cardiac chamber and atrial selectivity in patients with AF. METHODS: We analyzed 134 patients (60.4 +/- 12.5 years, M:F = 1.14:1) who were administered a single antiarrhythmic agent for AF over 6 months: amiodarone (group A), flecainide (group F), or propafenone (group P). The P wave, QRS complex duration and dispersion, and QT interval and its dispersion were evaluated using a standard 12-lead electrocardiogram. RESULTS: There was no significant difference in age, gender ratio, or associated diseases among the three groups. In group A, Pmax, Pmin, P dispersion, QRSmax, QRSmin, and QRS dispersion were shorter than in groups F and P, whereas Pmax/QRSmax was the highest in group A (A = 1.2, F = 0.9, P = 1.0; p < 0.01). QTcmax and QTcmin were longer in group A, whereas QTc dispersion and the QT peak to end (A = 13.3 +/- 11.2, F = 30.7 +/- 24.9, P = 31.8 +/- 21.6; p < 0.01) were shorter in group A than in the other groups. CONCLUSIONS: Amiodarone had a weaker, but more selective, inhibitory effect on intra-atrial conduction, and inhibited ventricular repolarization more effectively and homogenously than flecainide or propafenone. These differing electrophysiological effects may contribute to the superior effectiveness and safety of amiodarone over flecainide or propafenone.
Amiodarone ; Anti-Arrhythmia Agents ; Atrial Fibrillation ; Electrophysiology ; Flecainide ; Humans ; Propafenone

Anti-Arrhythmia Agents ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Humans

Humans ; Anti-Arrhythmia Agents/therapeutic use* ; China ; Consensus

Anti-Arrhythmia Agents ; Arrhythmias, Cardiac ; Electrocardiography ; Humans ; Tachycardia, Supraventricular

Many classes of drug, such as antineoplastic drugs and antiarrhythmic drugs, have potential to induce interstitial lung disease. Herbal medicines are also believed to have the potential to induce pneumonitis. However, to our knowledge, there are no reports of pneumonitis caused by herbal medications in the Korean medical database. We report a case of recurrent pneumonitis caused by a self rechallenge of the Herbal medicine Bojungikgitang (Bu-Zhong-Yi-Qi-Tang : Hochu-ekki-to).
Anti-Arrhythmia Agents ; Antineoplastic Agents ; Herbal Medicine ; Lung Diseases, Interstitial ; Pneumonia

We are presenting the first documented case of amisulpride related ventricular arrhythmia during tracheal intubation and extubation under general anesthesia in an 48 year-old female with psychiatric history of chronic schizophrenia who was treated with amisulpride. This case suggests the threshold of perioperative arrhythmia is possibly decreased in patients with long-term antipsychotic medication. So, the potential risk of antipsychotics-induced perioperative arrhythmia should be evaluated, as well as heart rhythm monitoring, prophylactic use of antiarrhythmic drugs, and preoperative adjustment of antipsychotics should be considered.
Anesthesia, General* ; Anti-Arrhythmia Agents ; Antipsychotic Agents ; Arrhythmias, Cardiac* ; Female ; Heart ; Humans ; Intubation* ; Schizophrenia

Anti-Arrhythmia Agents/blood ; Anti-Arrhythmia Agents/*pharmacology ; Blood Pressure/drug effects ; Cell Membrane/drug effects ; Disopyramide/blood ; Membrane Potentials/drug effects

In all clinical trials comparing rate versus rhythm control of atrial fibrillation (AF) by drugs, there was no survival benefit associated with a rhythm control strategy. Currently used antiarrhythmic drugs are not only frequently ineffective at eliminating AF, but may be life threatening in some patients. Catheter ablation (CA) of AF has evolved rapidly and has become accepted as one of the therapeutic modalities for controlling AF. The effective strategies for CA of AF consist of pulmonary vein isolation (PVI) and/or complete encirclement around PVs with or without additional ablation lines. Selection of patients, who may be benefited by CA or not, is an important issue. Precise electroanatomic mapping for the triggers and the substrate of the atria is central for customizing ablation target and for enhancing efficacy of CA for AF. With further development of new energy sources of ablation, cardiac imaging, navigation, and mapping systems, the CA can be simplified and standardized, which may enable the CA to become more effective, safer, and more applicable to many different subsets of AF.
Anti-Arrhythmia Agents ; Atrial Fibrillation ; Catheter Ablation ; Catheters ; Humans ; Pulmonary Veins

The authors have experienced, during general anesthesia with methoxyflurane-nitrous oxide- oxygen for explorative laparatomy to perform appendectomy, a case of acute pulmonary edema, which is rare and it's etiology is various. The patient had no specific past or family history and the only predisposing factor was myocardial ischemia caused by cardio-vascular collapse due to severe dehydration. In this case, the authors believed that pre-existing myocardial ischemia, rapid transfusion of 5% dextrose and myocardial depressants (methoxyflurane and d-tubocurarine) were the causative factors. For this reason at least, myocardial depressants should be avoided in severely dehydrated patients. There are many preventive measures and treatments for acute pulmonary edema during general anesthesia. As in this case, we believe that prompt recognition and attention by the anesthesiologists are the most important preventive and therapeutic measures.
Anesthesia, General* ; Anti-Arrhythmia Agents ; Appendectomy ; Causality ; Dehydration ; Edema* ; Glucose ; Humans ; Myocardial Ischemia ; Oxygen ; Pulmonary Edema