Types of proarrhythmia during treatment with antiarrhythmic drugs (AADs) for atrial fibrillation or atrial flutter according to the Vaughan Williams Classification

Ventricular proarrhythmia

• Torsade de pointes (Vaughan Williams class IA and type III drugs)

• Sustained monomorphic ventricular tachycardia (usually class IC drugs)

• Sustained polymorphic ventricular tachycardia/ventricular fibrillation without long QT interval (class IA, IC, and III drugs)

Atrial proarrhythmia

• Provocation of recurrence (probably class IA, IC, and III drugs)

• Conversion of atrial fibrillation (AF) to atrial flutter (usually class IC drugs) with 1:1 conduction

• Increase of defibrillation threshold (a potential problem with class IC drugs)

Abnormalities of conduction or impulse formation

• Accelerate ventricular rate during AF (class IA and type IC drugs)

• Accelerate conduction over accessory pathway (digoxin, type IV drugs)

• Sinus node dysfunction, atrioventricular block (almost all drugs)

Vaughan Williams classification of AADs used for the treatment of atrial fibrillation or flutter

Class IA - Disopyramide, procainamide, quinidine

Class IC - Flecainide, propafenone

Class III - Amiodarone, dofetilide, ibutilide, sotalol

Class IV - Nondihydropyridine calcium channel blockers (diltiazem and verapamil)

Data from Fuster V, Ryden LE, Cannom DS, et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing committee to revise the 2001 guidelines for the management of patients with atrial fibrillation). J Am Coll Cardiol 2006; 48:e149.

Graphic 66133 Version 4.0

خرید پکیج

Types of proarrhythmia during treatment with antiarrhythmic drugs (AADs) for atrial fibrillation or atrial flutter according to the Vaughan Williams Classification