Antiarrhythmic agents for chronic XXXX .

@entity1 @entity1164 @entity2643 @entity137 @entity712 @entity11808 @entity6237 @entity5126 @entity7306 @entity943
A vast array of new antiarrhythmic agents have joined the old agents among the clinician's available resources. While treatment of @entity943 is completely justifiable for @entity1 with symptoms, their use to prevent @entity1164 has not yet been established. Because of their potential risks, the benefit/risk ratio must always be kept in mind. If we elect to treat @entity1 who have benign or potentially lethal @entity943 (usually to eliminate refractory symptoms) we typically begin with either a beta blocker or one of the new potent class IC antiarrhythmic agents such as @entity6237 or @entity11808 . These drugs cause few side effects, no organ @entity137 , and in the case of @entity11808 or @entity6237 , have marked potency. Few important proarrhythmic effects are seen with these potent drugs in this group of @entity1 . If these fail, one can try either a class IA or IB agent or a combination of a IA and IB agent. We always avoid @entity2643 . In @entity1 with lethal @entity943 , one should choose a drug without negative inotropic potential such as @entity5126 or @entity11808 as initial therapy. The combination of IA and IB agents should also be considered early in therapy. In @entity1 with overt @entity712 with markedly depressed left ventricular function in the setting of lethal @entity943 , @entity7306 , beta blockers, and @entity6237 should be avoided. @entity2643 is used in this population only when the other available agents have proven to be ineffective or badly tolerated.
