Intravenous antiarrhythmic agents.
Intravenous antiarrhythmic drugs can be used as diagnostic tools; for example, adenosine can be used to reveal the underlying rhythm in narrow QRS tachycardia. Newer class III antiarrhythmic agents, like ibutilide and dofetilide, are effective at the conversion of acute atrial fibrillation; however, electrical cardioversion is still the most effective method for restoration of sinus rhythm in persistent atrial fibrillation. Lidocaine and bretylium in the treatment and prevention of ventricular tachyarrhythmia are de-emphasized because of inefficacy, safety concerns (lidocaine), or shortage of drug (bretylium). Procainamide is effective for stable ventricular tachycardia, and amiodarone is effective in the treatment of shock-refractory ventricular fibrillation. Adrenergic blockade is likely important in the management of tachyarrhythmias, particularly in electrical storm, but more data will be necessary to establish its role.
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St. Michael's Hospital, Toronto, Ontario, Canada. dorianp@smh.toronto.on.ca  
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D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D011342:Procainamide / Q000627:therapeutic use; D011405:Propafenone / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000517:prevention & control
D000889:Anti-Arrhythmia Agents; D011405:Propafenone; D011342:Procainamide; D000638:Amiodarone