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CARDIAC ARRYHTHMIASNot all ECG documented arrhythmias require treatment.The physician must consider the balance between the symptomatic andprognostic significance of the arrhythmia and the potential side effects of thetherapy.Arrhythmias may arise either from abnormal automaticity triggered afterdepolarization or from disorders of impulse conduction e.g. re-entryphenomenon. Examples of re-entry phenomenon include;oAtrial flutter and fibrillationoSupraventricular tachycardiaoVentricular tachycardiaoVentricular fibrillationTrigger activity is the likely basis for the arrhythmias of digitalis toxicity.Supraventricular Tachycardia(re-entry phenomenon)Supraventricular Tachycardia(re-entry phenomenon)VentricularTachycardia(re-entryPhenomenon)Normal Sinus rhythmAtrialFibrillationClassification of anti-arrhythmic drugs;(Vaughan Williams Classification)ClassDrugsI. Fast sodium channel inhibitorsIa; Quinidine, procainamide, disopyramideIb; Lidocaine, phenytoin, mexiletine, tocainideIc; Flecainide, propafenoneII. Antisympathetic agentsBeta-blockers; e.g. atenolol, propranolol,metoprololIII. Prolongation of action potentialdurationAmiodarone, bretylium, sotalolIV. Slow calcium channel antagonistsVerapamil, diltiazemNot ClassifiedDigoxin, adenosineCardiac Action PotentialClass I action;Also referred to as fast sodium channel inhibitorsAgents with class I activity block sodium channels and reduce th ...


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