What is the role of class I antiarrhythmics in the treatment of atrial flutter?

Updated: Nov 09, 2018
  • Author: Jesse Borke, MD, FACEP, FAAEM; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Class I antiarrhythmic agents are used for chemical conversion into sinus rhythm. They alter the electrophysiologic mechanisms responsible for arrhythmias. As discussed earlier, it is dangerous to administer procainamide prior to slowing the AV node conduction (eg, with diltiazem), as slowing the atrial rate prior to the AV conduction rate can actually increase the ventricular rate by the induction of a lower conduction ratio (eg, inducing a 1:1 conduction at a rate of 200 bpm from a 2:1 conduction at a rate of 300 A/150 V)!

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