Use of intravenous dofetilide in atrial flutter with hemodynamic instability.
Paroxysmal atrial flutter is a drug-resistant supraventricular tachyarrhythmia that is often accompanied by hemodynamic instability due to an excessive ventricular response. We report here a case of atrial flutter with 1:1 atrioventricular conduction, in which we were able to rescue the patient from a state of cardiogenic shock by using intravenous dofetilide, a new class III antiarrhythmic agent. Dofetilide was suitable for the treatment because it immediately increased atrioventricular nodal refractoriness without any negative inotropic action.
Kuruma
A
A
First Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Atarashi
H
H
Ino
T
T
Yashima
M
M
Nomura
A
A
Hayakawa
H
H
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001282:Atrial Flutter / Q000188:drug therapy* / Q000503:physiopathology; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D006801:Humans; D007275:Injections, Intravenous; D010627:Phenethylamines / Q000008:administration & dosage*; D013449:Sulfonamides / Q000008:administration & dosage*
D000889:Anti-Arrhythmia Agents; D010627:Phenethylamines; D013449:Sulfonamides; C063533:dofetilide