Congestive heart failure antiarrhythmic drugs: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
(/* Antiarrhythmics in Patients Presenting With Heart Failure (DO NOT EDIT) Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, S...)
(/* 2022 2017 AHA/ ACC/ HFSA Heart Failure Guidelines (DO NOT EDIT) {{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=1...)
 
(4 intermediate revisions by 3 users not shown)
Line 10: Line 10:
|}
|}
{{Congestive heart failure}}
{{Congestive heart failure}}
{{CMG}}; {{AOEIC}} {{LG}}
{{CMG}}; {{AOEIC}} {{LG}} {{EdzelCo}}


==Overview==
==Overview==
Antiarrhythmic therapy can be considered as part of a therapeutic strategy to prevent [[sudden cardiac death]].  Over 50% of heart failure patients will have asymptomatic non-sustained [[ventricular tachycardia]] (NSVT) and it is generally not recommended that NSVT be treated.   
[[Antiarrhythmic therapy]] can be considered as part of a [[therapeutic strategy]] to prevent [[sudden cardiac death]].  Over 50% of [[heart failure]] [[patients]] will have [[asymptomatic]] [[non-sustained [[ventricular tachycardia]] ([[NSVT]]) and it is generally not recommended that [[NSVT]] be treated.   


==Antiarrhythmic Drugs==
==Antiarrhythmic Drugs==
There are multiple causes of [[sudden cardiac death]] in the patient with congestive heart failure which include not only [[arrhythmic]] causes, but also thrombotic and other causes:
There are multiple causes of [[sudden cardiac death]] in the [[patient]] with [[congestive heart failure]] which include not only [[arrhythmic]] causes, but also [[thrombotic]] and other causes:
*Arrhythmic causes
*Arrhythmic causes
*:[[Ventricular tachycardia]]
*:[[Ventricular tachycardia]]
Line 22: Line 22:
*:[[Bradyarrhythmias]]
*:[[Bradyarrhythmias]]


*Thrombotic causes:
*[[Thrombotic]] causes:
*:[[Acute MI]]
*:[[Acute MI]]
*:[[Pulmonary embolism]]
*:[[Pulmonary embolism]]
Line 29: Line 29:
*:[[Hyperkalemia]]
*:[[Hyperkalemia]]


===Metabolism of Antiarrhythmics in the setting of Congestive Heart Failure===
===[[Metabolism]] of [[Antiarrhythmics]] in the setting of [[Congestive Heart Failure]]===
The metabolism of following anti-arrhythmic drugs are significantly affected in patients with [[congestive heart failure]] and care should be taken regarding their administration:
The [[metabolism]] of following [[anti-arrhythmic drugs]] are significantly affected in [[patients]] with [[congestive heart failure]] and care should be taken regarding their administration:


#[[Quinidine]]
#[[Quinidine]]
Line 43: Line 43:
#[[Amiodarone]]
#[[Amiodarone]]


Patients with congestive heart failure should not be treated with [[dronedarone]].
[[Patients]] with [[congestive heart failure]] should not be treated with [[dronedarone]].


== 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure (DO NOT EDIT) <ref name="pmid23747642">{{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE et al.| title=2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2013 | volume=  | issue=  | pages=  | pmid=23747642 | doi=10.1016/j.jacc.2013.05.019 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23747642  }} </ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID:[http://pubmed.gov/19324967 19324967]</ref><ref name="pmid28461007">{{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Colvin MM et al.| title=2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. | journal=J Am Coll Cardiol | year= 2017 | volume= 70 | issue= 6 | pages= 776-803 | pmid=28461007 | doi=10.1016/j.jacc.2017.04.025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28461007 }} </ref>==
== 2022 AHA/ ACC/ HFSA Heart Failure Guidelines (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref> ==


===Antiarrhythmics in Patients Presenting With Heart Failure (DO NOT EDIT) <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>===


{|class="wikitable" style="width:80%"
{|class="wikitable" style="width:80%"
|-
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
| colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Drugs known to adversely affect the clinical status of patients with current or prior symptoms of [[heart failure]] and reduced [[left ventricular ejection fraction]] ([[LVEF]]) should be avoided or withdrawn whenever possible (e.g., [[NSAID|nonsteroidal anti-inflammatory drugs]], most [[Antiarrhythmic agent|antiarrhythmic drugs]], and most [[Calcium channel blocker|calcium channel blocking drugs]].<ref name="pmid9605782">{{cite journal |author=Heerdink ER, Leufkens HG, Herings RM, Ottervanger JP, Stricker BH, Bakker A |title=NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics |journal=[[Archives of Internal Medicine]] |volume=158 |issue=10 |pages=1108–12 |year=1998 |month=May |pmid=9605782 |doi= |url=http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=9605782 |accessdate=2012-04-05}}</ref><ref name="pmid2703968">{{cite journal |author=Herchuelz A, Derenne F, Deger F, Juvent M, Van Ganse E, Staroukine M, Verniory A, Boeynaems JM, Douchamps J |title=Interaction between nonsteroidal anti-inflammatory drugs and loop diuretics: modulation by sodium balance |journal=[[The Journal of Pharmacology and Experimental Therapeutics]] |volume=248 |issue=3 |pages=1175–81 |year=1989 |month=March |pmid=2703968 |doi= |url=http://jpet.aspetjournals.org/cgi/pmidlookup?view=long&pmid=2703968 |accessdate=2012-04-05}}</ref><ref name="pmid1529943">{{cite journal |author=Gottlieb SS, Robinson S, Krichten CM, Fisher ML |title=Renal response to indomethacin in congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy |journal=[[The American Journal of Cardiology]] |volume=70 |issue=9 |pages=890–3 |year=1992 |month=October |pmid=1529943 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0002-9149(92)90733-F |accessdate=2012-04-05}}</ref><ref name="pmid1655327">{{cite journal |author=Bank AJ, Kubo SH, Rector TS, Heifetz SM, Williams RE |title=Local forearm vasodilation with intra-arterial administration of enalaprilat in humans |journal=[[Clinical Pharmacology and Therapeutics]] |volume=50 |issue=3 |pages=314–21 |year=1991 |month=September |pmid=1655327 |doi= |url= |accessdate=2012-04-05}}</ref><ref name="pmid2473403">{{cite journal |author= |title=Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators |journal=[[The New England Journal of Medicine]] |volume=321 |issue=6 |pages=406–12 |year=1989 |month=August |pmid=2473403 |doi=10.1056/NEJM198908103210629 |url=http://www.nejm.org/doi/abs/10.1056/NEJM198908103210629?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed |accessdate=2012-04-05}}</ref><ref name="pmid1377359">{{cite journal |author= |title=Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators |journal=[[The New England Journal of Medicine]] |volume=327 |issue=4 |pages=227–33 |year=1992 |month=July |pmid=1377359 |doi=10.1056/NEJM199207233270403 |url=http://dx.doi.org/10.1056/NEJM199207233270403 |accessdate=2012-04-05}}</ref><ref name="pmid2476016">{{cite journal |author=Pratt CM, Eaton T, Francis M, Woolbert S, Mahmarian J, Roberts R, Young JB |title=The inverse relationship between baseline left ventricular ejection fraction and outcome of antiarrhythmic therapy: a dangerous imbalance in the risk-benefit ratio |journal=[[American Heart Journal]] |volume=118 |issue=3 |pages=433–40 |year=1989 |month=September |pmid=2476016 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0002-8703(89)90254-8 |accessdate=2012-04-05}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''4.'''In [[patients]] with [[HFrEF]], class IC [[antiarrhythmic]] [[medications]] and [[dronedarone]] may increase the risk of [[mortality]]. <ref name="pmid1900101">{{cite journal| author=Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH | display-authors=etal| title=Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. | journal=N Engl J Med | year= 1991 | volume= 324 | issue= 12 | pages= 781-8 | pmid=1900101 | doi=10.1056/NEJM199103213241201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1900101  }} </ref><ref name="pmid8691967">{{cite journal| author=Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF | display-authors=etal| title=Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. | journal=Lancet | year= 1996 | volume= 348 | issue= 9019 | pages= 7-12 | pmid=8691967 | doi=10.1016/s0140-6736(96)02149-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8691967  }} </ref><ref name="pmid18565860">{{cite journal| author=Køber L, Torp-Pedersen C, McMurray JJ, Gøtzsche O, Lévy S, Crijns H | display-authors=etal| title=Increased mortality after dronedarone therapy for severe heart failure. | journal=N Engl J Med | year= 2008 | volume= 358 | issue= 25 | pages= 2678-87 | pmid=18565860 | doi=10.1056/NEJMoa0800456 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18565860  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|}
|}


=====[[Management]] of Stage C [[HF]]: [[Ivabadrine]]=====
{|class="wikitable" style="width:80%"
{|class="wikitable" style="width:80%"
|-
|-
| colspan="1" style="text-align:center; background: LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
 
| bgcolor="LemonChiffon"|
'''1.'''
Ivabradine can be beneficial to reduce HF hospitalization for patients with symptomatic (NYHA class II-III) stable chronic HFrEF (LVEF ≤ 35%) who are receiving GDEM*, including a beta blocker at maximum tolerated dose, and who are in sinus rhythm with a heart rate of 70 bpm or greater at rest.
([[ACC AHA guidelines classification scheme#Level of Evidence|Class IIa, Level of Evidence: B-R]])
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' For [[patients]] with [[symptomatic]] ([[NYHA]] class II to III) stable chronic [[HFrEF]] ([[LVEF]] ≤ 35%) who are receiving GDMT, including a [[beta blocker]] at maximum tolerated [[dose]], and who are in [[sinus rhythm]] with a [[heart rate]] of ≥70 bpm at rest, [[ivabradine]] can be beneficial to reduce [[HF]] [[hospitalizations]] and [[cardiovascular death]]. <ref name="pmid20801500">{{cite journal| author=Swedberg K, Komajda M, Böhm M, Borer JS, Ford I, Dubost-Brama A | display-authors=etal| title=Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. | journal=Lancet | year= 2010 | volume= 376 | issue= 9744 | pages= 875-85 | pmid=20801500 | doi=10.1016/S0140-6736(10)61198-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20801500  }} </ref><ref name="pmid22927555">{{cite journal| author=Borer JS, Böhm M, Ford I, Komajda M, Tavazzi L, Sendon JL | display-authors=etal| title=Effect of ivabradine on recurrent hospitalization for worsening heart failure in patients with chronic systolic heart failure: the SHIFT Study. | journal=Eur Heart J | year= 2012 | volume= 33 | issue= 22 | pages= 2813-20 | pmid=22927555 | doi=10.1093/eurheartj/ehs259 | pmc=3498004 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22927555  }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
|}
|}


Line 71: Line 69:


==External Links==
==External Links==
*[https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000001063.full.pdf 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines]<ref name="pmid35363499">{{cite journal |vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW |title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines |journal=Circulation |volume=145 |issue=18 |pages=e895–e1032 |date=May 2022 |pmid=35363499 |doi=10.1161/CIR.0000000000001063 |url=}} </ref>
*[http://circ.ahajournals.org/content/112/12/e154.full.pdf The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult] <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref>
*[http://circ.ahajournals.org/content/112/12/e154.full.pdf The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult] <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref>


Line 77: Line 77:
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}


[[Category:Cardiology]]
[[Category:Cardiology]]
Line 83: Line 85:
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[Category:Medicine]]
[[Category:Medicine]]
[[Category:Primary care]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date cardiology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Latest revision as of 21:29, 22 June 2022
Resident
Survival
Guide
File:Critical Pathways.gif

Congestive Heart Failure Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Systolic Dysfunction
Diastolic Dysfunction
HFpEF
HFrEF

Causes

Differentiating Congestive heart failure from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Clinical Assessment

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Cardiac MRI

Echocardiography

Exercise Stress Test

Myocardial Viability Studies

Cardiac Catheterization

Other Imaging Studies

Other Diagnostic Studies

Treatment

Invasive Hemodynamic Monitoring

Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
Hydralazine
Positive Inotropics
Anticoagulants
Angiotensin Receptor-Neprilysin Inhibitor
Antiarrhythmic Drugs
Nutritional Supplements
Hormonal Therapies
Drugs to Avoid
Drug Interactions
Treatment of underlying causes
Associated conditions

Exercise Training

Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure antiarrhythmic drugs On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Congestive heart failure antiarrhythmic drugs

CDC on Congestive heart failure antiarrhythmic drugs

Congestive heart failure antiarrhythmic drugs in the news

Blogs on Congestive heart failure antiarrhythmic drugs

Directions to Hospitals Treating Congestive heart failure antiarrhythmic drugs

Risk calculators and risk factors for Congestive heart failure antiarrhythmic drugs

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2] Edzel Lorraine Co, DMD, MD[3]

Overview

Antiarrhythmic therapy can be considered as part of a therapeutic strategy to prevent sudden cardiac death. Over 50% of heart failure patients will have asymptomatic [[non-sustained ventricular tachycardia (NSVT) and it is generally not recommended that NSVT be treated.

Antiarrhythmic Drugs

There are multiple causes of sudden cardiac death in the patient with congestive heart failure which include not only arrhythmic causes, but also thrombotic and other causes:

Metabolism of Antiarrhythmics in the setting of Congestive Heart Failure

The metabolism of following anti-arrhythmic drugs are significantly affected in patients with congestive heart failure and care should be taken regarding their administration:

  1. Quinidine
  2. Procainamide
  3. Disopyramide: Contraindicated in patients with heart failure.
  4. Moricizine
  5. Lidocaine
  6. Mexiletine
  7. Tocainide
  8. Flecainide
  9. Propafenone
  10. Amiodarone

Patients with congestive heart failure should not be treated with dronedarone.

2022 AHA/ ACC/ HFSA Heart Failure Guidelines (DO NOT EDIT) [1]

Class III (Harm)
"4.In patients with HFrEF, class IC antiarrhythmic medications and dronedarone may increase the risk of mortality. [2][3][4] (Level of Evidence: A) "
Management of Stage C HF: Ivabadrine
Class IIa
"1. For patients with symptomatic (NYHA class II to III) stable chronic HFrEF (LVEF ≤ 35%) who are receiving GDMT, including a beta blocker at maximum tolerated dose, and who are in sinus rhythm with a heart rate of ≥70 bpm at rest, ivabradine can be beneficial to reduce HF hospitalizations and cardiovascular death. [5][6](Level of Evidence: B-R) "

Vote on and Suggest Revisions to the Current Guidelines

External Links

References

  1. ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  2. ↑ Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH; et al. (1991). "Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial". N Engl J Med. 324 (12): 781–8. doi:10.1056/NEJM199103213241201. PMID 1900101.
  3. ↑ Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF; et al. (1996). "Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol". Lancet. 348 (9019): 7–12. doi:10.1016/s0140-6736(96)02149-6. PMID 8691967.
  4. ↑ Køber L, Torp-Pedersen C, McMurray JJ, Gøtzsche O, Lévy S, Crijns H; et al. (2008). "Increased mortality after dronedarone therapy for severe heart failure". N Engl J Med. 358 (25): 2678–87. doi:10.1056/NEJMoa0800456. PMID 18565860.
  5. ↑ Swedberg K, Komajda M, Böhm M, Borer JS, Ford I, Dubost-Brama A; et al. (2010). "Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study". Lancet. 376 (9744): 875–85. doi:10.1016/S0140-6736(10)61198-1. PMID 20801500.
  6. ↑ Borer JS, Böhm M, Ford I, Komajda M, Tavazzi L, Sendon JL; et al. (2012). "Effect of ivabradine on recurrent hospitalization for worsening heart failure in patients with chronic systolic heart failure: the SHIFT Study". Eur Heart J. 33 (22): 2813–20. doi:10.1093/eurheartj/ehs259. PMC 3498004. PMID 22927555.
  7. ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW (May 2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check |pmid= value (help).
  8. ↑ Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202
  9. ↑ Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967

Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Congestive_heart_failure_antiarrhythmic_drugs&oldid=1726649"