Which medications in the drug class Antidysrhythmics, Class IV are used in the treatment of Atrial Flutter?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Antidysrhythmics, Class IV

Class IV antiarrhythmic drugs are used as rate control agents. They affect calcium channels by inhibiting calcium ions from entering areas of the vascular smooth muscle and myocardium during depolarization. These agents also slow automaticity and conduction of the AV node.

Diltiazem (Cardizem, Cardizem CD, Cardizem LA, Cartia XT)

Diltiazem is a nondihydropyridine calcium channel blocker that produces relaxation of coronary vascular smooth muscle and coronary vasodilation by inhibiting calcium ions from entering the "slow channels" and myocardium during depolarization. Intravenous (IV) diltiazem is indicated for control of rapid ventricular rate in patients with atrial fibrillation or atrial flutter.

Verapamil (Calan, Isoptin, Verelan)

During depolarization, verapamil inhibits calcium ions from entering slow channels and voltage-sensitive areas of vascular smooth muscle and myocardium. It can diminish premature ventricular contractions (PVCs) associated with perfusion therapy and decrease the risk of ventricular fibrillation and ventricular tachycardia. By interrupting reentry at the AV node, it can restore normal sinus rhythm in patients with paroxysmal SVT.

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