Confidence, Consensus & Continuation of Anti- Arrhythmic Drugs in ...
Confidence, Consensus & Continuation of Anti- Arrhythmic Drugs in ...
Confidence, Consensus & Continuation of Anti- Arrhythmic Drugs in ...
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Choice <strong>of</strong> <strong>Anti</strong>arrhythmic Drug Accord<strong>in</strong>g to<br />
Underly<strong>in</strong>g Pathology<br />
M<strong>in</strong>imal or no heart disease<br />
Significant underly<strong>in</strong>g heart disease<br />
Prevention <strong>of</strong> remodell<strong>in</strong>g<br />
ACEI/ARB/stat<strong>in</strong><br />
β blockade where appropriate<br />
Treatment <strong>of</strong> underly<strong>in</strong>g condition and prevention/reversal <strong>of</strong><br />
remodell<strong>in</strong>g – ACEI/ARB/stat<strong>in</strong>. β blockade where appropriate<br />
HT<br />
CAD<br />
CHF<br />
No LVH LVH Stable NYHA III/IV<br />
NYHA I/II or ‘unstable’<br />
NYHA II<br />
Dronedarone / Fleca<strong>in</strong>ide /<br />
Propafenone / Sotalol<br />
Dronedarone<br />
Dronedarone<br />
Sotalol<br />
Dronedarone<br />
Amiodarone<br />
Amiodarone<br />
Amiodarone<br />
NYHA = New York Heart Association<br />
‘Unstable’ = cardiac decompensation with<strong>in</strong> the prior 4 weeks<br />
= evidence for ‘upstream’ therapy for prevention <strong>of</strong> atrial remodell<strong>in</strong>g still rema<strong>in</strong>s controversial<br />
CAD: coronary artery disease; CHF: congestive heart failure<br />
HT: hypertension; LVH: left ventricular hypertrophy<br />
Adapted from: Camm AJ, et al. Eur Heart J 2010;31:2369–2429<br />
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