title: Advances in oral anti arrhythmic therapy: implications for the anaesthetist.
abstract: Surgical patients often are receiving antiarrhythmic therapy. Thus, because anaesthetic agents can affect cardiac function and may interact with concurrent antiarrhythmic medications, the anaesthetist should be aware of the electrophysiology associated with dysrhythmias and their management. Tocainide, flecainide, mexiletine, encainide and amiodarone have been introduced recently and each has an unique pattern of bioavailability, metabolism and toxicity. Patients treated with these drugs need special concern as they have abnormal cardiovascular systems and may be at increased risk for perioperative morbidity. In addition, unexpected untoward reactions and toxicity can result from interactions of anaesthetic agents and these drugs. This review discusses normal cardiac electrophysiology, common dysrhythmias and the electrophysiological effects of the newer oral antiarrhythmic drugs.
authors.affiliation: Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, 223 Burnett Womack Bldg. 229H, CB #7010, 27599-7010, Chapel Hill, NC, USA.|Department of Anesthesiology, Rex Hospital, Raleigh, NC, USA.
authors.forename: Warner J
authors.initials: WJ
authors.lastname: Lucas
authors.affiliation: Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, 223 Burnett Womack Bldg. 229H, CB #7010, 27599-7010, Chapel Hill, NC, USA.|Department of Anesthesiology, Rex Hospital, Raleigh, NC, USA.
authors.forename: Gerald A
authors.initials: GA
authors.lastname: Maccioli
authors.affiliation: Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, 223 Burnett Womack Bldg. 229H, CB #7010, 27599-7010, Chapel Hill, NC, USA.|Department of Anesthesiology, Rex Hospital, Raleigh, NC, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Mueller
keywords: COMPLICATIONS: arrhythmia; HEART: antiarrhythmics, amiodarone, encainide, flecainide, mexiletine, tocainide; TOXICITY: amiodarone, encainide, flecainide