Recent advances in the treatment of arrhythmias have stemmed from careful observation and monitoring in postoperative intensive care areas and from the renewed interest of physicians in the arrhythmias after myocardial infarction. The basic treatment of arrhythmias is the same whenever they occur. Although a knowledge of the electrophysiological changes leading to arrhythmias (Hoffman and Crane...

Pharmacological management of cardiac arrhythmias has been a long and widely sought goal. One of the difficulties in treating arrhythmia stems, in part, from incomplete understanding of the mechanisms of drug block and how intrinsic properties of channel gating affect drug access, binding affinity, and unblock. In the last decade, a plethora of genetic information has revealed that genetics may...

BACKGROUND Right atrial flutter cycle length can prolong in the presence of antiarrhythmic drug therapy. We hypothesized that the cycle length of right atrial isthmus dependent flutter would correlate with right atrial cross-sectional area measurements. METHODS 60 patients who underwent ablation for electrophysiologically proven isthmus dependent right atrial flutter, who were not on Class I ...

INTRODUCTION AND OBJECTIVES The best therapeutic approach for persistent atrial fibrillation has yet to be defined. Our aim was to investigate the effects of cardioversion in unselected patients with persistent atrial fibrillation who were treated according to a strict protocol involving pretreatment, cardioversion, and follow-up. METHODS Consecutive patients with persistent atrial fibrillati...

Radiofrequency ablation (RFA) for the treatment of paroxysmal Atrial Fibrillation (pAF) has a class 1 indication in patients who have not tolerated or responded to antiarrhythmic medications. Antiarrhythmic medications (AAM) are, however, limited not only by modest efficacy, but also by significant side effects. Discontinuation rates for AAM range from 11-40% in trials. The RAAFT-2 trial evalua...

THE action of antiarrhythmic drugs on heart muscle has been studied extensively by electrophysiologic and biochemical technics. There is general agreement that a common property of the antiarrhythmic drugs now in clinical use is the ability to decrease the excitability of the myocardium. There are many possible ways in which such an action could be brought about. One suggestion is that such dru...

A comparison of the antiarrhythmic effects of 2 mg/kg of mepivacaine and lignocaine, as measured by elevations in the end-diastolic ventricular stimulation threshold (EDVST), was made in open-chest dogs. Both mepivacaine and lignocaine increased the EDVST significantly. The peak elevation of EDVST occurred within 2 minutes after injection and averaged 0.013 mA (13 ,uA) with mepivacaine and 0.02...

our approach to the management of atrial fibrillation (AF).1 This can largely be attributed to the advent of catheter ablation therapy which has proven to be significantly more efficacious in achieving arrhythmia control than antiarrhythmic drugs.2-4 However, despite these developments, there is paucity of data on the natural history of this arrhythmia and studies that have been conducted so fa...

Atrial tachycardia is an uncommon arrhythmia and may be focal or macroreentrant. This review concentrates on focal atrial tachycardia. Over the last decade there have been a number of advances in delineating the mechanism and anatomic locations of focal atrial tachycardia. The lack of efficacy of antiarrhythmic therapy and the advent of radiofrequency ablation have altered our primary approach ...

Mexiletine is a commonly used Class IB (Vaughan William classification) antiarrhythmic drug. We report a case of mexiletine-induced psychosis that was successfully managed by decreasing the dose and using alternative medications for management of ventricular tachycardia.