Skip to main content
SpringerLink
Log in

Interactions of antiarrhythmic drugs with implantable defibrillator therapy for atrial and ventricular tachyarrhythmias

  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Implantable cardioverter defibrillators (ICDs) have proven highly successful in the treatment of recurrent ventricular and atrial arrhythmias. Despite their high efficacy in terminating arrhythmias, concomitant therapy with antiarrhythmic drugs in ICD recipients remains common. Antiarrhythmic drugs are employed in an attempt to to limit patient exposire to high-energy shocks, primarily by reducing the number of arrhythmia reccurrences, suppressing coexisting arrhythmias, affecting rate and organization of tachycardias, and increasing efficacy of painless pacing therapies. Data regarding interaction of antiarrhythmic drugs with ICDs are incomplete and mostly based on animal models; however, it is clear that antiarrhythmic drugs affect all aspects of function of devices such as defibriallation threshold, pacing threshold, and sensing of both atrial and and ventricular arrhythmias. Because significant change in any of these functions may result in a nonfunctional device, and magnitude of drug effect in an individual patient is unpredictable, careful assessment of ICD function after an institution of therapy with antiarrhythmic drugs is mandatory.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Echt DS, Liebson PR, Mitchell LB, et al.: Mortality and morbidity in patients receiving encainide, flecainide or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med 1991, 324:781–788.

    Article  PubMed  CAS  Google Scholar 

  2. Waldo AL, Camm AJ, deRuyter H, et al., for the SWORD Investigators. Effects of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. Lancet 1996, 348:7–12.

    Article  PubMed  CAS  Google Scholar 

  3. Siebels J, Kuck K-H, and the CASH Investigators: Implantable cardioverter defibrillator compared with antiarrhythmic drug treatment in cardiac arrest survivors (the Cardiac Arrest Study Hamburg). Am Heart J 1994, 127(Suppl):1139–1144.

    Article  PubMed  CAS  Google Scholar 

  4. Mason JW, for the ESVEM Investigators: A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. N Engl J Med 1993, 329:445–451.

    Article  PubMed  CAS  Google Scholar 

  5. Burkart F, Pfister M, Kiowski W, et al.: Effect of antiarrhythmic therapy on mortality in survivors of myocardial infarction with asymptomatic complex ventricular arrhythmias: Basel Antiarrhythmic Study of Infarct Survival (BASIS). J Am Coll Cardiol 1990, 16:1711–1718.

    Article  PubMed  CAS  Google Scholar 

  6. Doval HC, Nul DR, Grancelli HO, et al., for the Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA): Randomised trial of low-dose amiodarone in severe congestive heart failure. Lancet 1994, 344:493–498.

    Article  PubMed  CAS  Google Scholar 

  7. Ceremuzynski L, Kleczar E, Krzeminska-Pakula M, et al.: Effect of amiodarone on mortality after myocardial infarction: A double-blind, placebo-controlled pilot study. J Am Coll Cardiol 1992, 20:1056–1062.

    Article  PubMed  CAS  Google Scholar 

  8. Singh SN, Fletcher RD, Fisher SG, et al., for the Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure: Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. N Engl J Med 1995, 333:77–82.

    Article  PubMed  CAS  Google Scholar 

  9. Cairns JA, Connolly SJ, Roberts R, Gent M: Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisation: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators Lancet 1997 349:675–682.

    Article  PubMed  CAS  Google Scholar 

  10. Julian DG, Camm AJ, Frangin g, et al.: Randomised trial of effect amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. Lancet 1997, 349 667–674.

    Article  PubMed  CAS  Google Scholar 

  11. The Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators: A comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med 1997, 337:1575–1583.

    Google Scholar 

  12. The CASCADE Investigators: Randomized antiarrhythmic drug therapy in survivors of cardiac arrest. [The CASCADE Study] Am J Cardiol 1993, 72:280–287.

    Article  Google Scholar 

  13. Bigger JT Jr.: Prophylatic use of implanted cardiac defibrillators in patients at high rigk for ventricular arrhythmias after coronaryartery bypass graft surgery. Coronary Artery Bypass Graft (CABG) Patch Trial Investigators N Engl J Med 1997, 337:1569–1575.

    Article  PubMed  Google Scholar 

  14. Moss AJ, Hall WJ, Cannom DS, et al., and the MADIT Investigators: Improved survival with an implanted defibrillator in patients with coronary artery disease at high risk for ventricular arrhythmia. N Engl J Med 1996 335:1933–1940.

    Article  PubMed  CAS  Google Scholar 

  15. Connolly SJ, Gent M, Roberts RS, et al., on behalf of the CIDS Co-Investigators: Canadian Implantable Defibrillator Study (CIDS): Study design and organization. Am J Cardiol 1993, 72:103F-108F.

    Article  PubMed  CAS  Google Scholar 

  16. Wever EFD, Hauer RNW, van Capelle FJL, et al.: Randomize study of implantable defibrillator as first-choice therapy versus conventional strategy in post infarct sudden death survivors. Circulation 1995, 91:2195–2203.

    PubMed  CAS  Google Scholar 

  17. Larsen GC, McAnult JH, Hallstrom A, et al.: Hospitalization changes in the Antiarrhythmics Versus Implantable Defibrillators (AVID) Trial: the AVID economic analysis stud [abstract]. Circulation 1997 96(Suppl1):1–77.

    Google Scholar 

  18. Fogoros RN, Fielder SB, Elson JJ: The automatic implantable cardioverter-defibrillator in drug-refractory ventricular tachyarrhythmias Ann Intern Med 1987, 107:635–641.

    PubMed  CAS  Google Scholar 

  19. Kelly PA, Cannom DS, Garan H, et al.: The automatic implantable cardioverter defibrillator: efficacy, complications and survival in patients with malignant ventricular arrhythmias. J Am Coll Cariol 1988, 11:1278–1286.

    Article  CAS  Google Scholar 

  20. Tchou PJ, Kadri N, Anderson J, et al.: Automatic implantable cardioverter defibrillators and survival of patients with left ventricular dysfunction and malignant ventricular arrhythmias. Ann Intern Med 1988, 109:529 534.

    PubMed  Google Scholar 

  21. Myerburg RJ, Luceri RM, Thurer R, et al.: Time to first shock and clinical outcome in patients receiving an automatic implantable cardioverter-defibrillator. J Am Coll Cardiol 1989, 14:508–514.

    Article  PubMed  CAS  Google Scholar 

  22. The PCD Investigator Group: Clinical outcome of patients with malignant ventricular tachyarrhythmias and a multiprogrammable cardioverter-defibrillator implanted with or without thoracotomy: An international multicenter study. J Am Coll Cardiol 1994, 23:1521–1530.

    Article  Google Scholar 

  23. Echt DS, Armstrong K, Schmidt P, et al.: Clinical experience, complications, and survival in 70 patients with the automatic implantable cardioverter/ defibrillator. Circulation 1985, 71:289–296.

    PubMed  CAS  Google Scholar 

  24. Winkle RA, Mead RH, Ruder MA, et al.: Long-term outcome with the automatic implantable cardioverter-defibrillator. J Am Coll Cardiol 1989, 13:1353–1361.

    Article  PubMed  CAS  Google Scholar 

  25. Fromer M, Brachmann J, Block M, et al.: Efficacy of multimodal device therapy for ventricular tachyarrhythmias as delivered by a new implantable pacing cardioverterdefibrillator. Results of a European multicenter study of 102 implants. Circulation 1992, 86:363 374.

    PubMed  Google Scholar 

  26. Bardy GH, Troutman C, Poole JE, et al.: Clinical experienc with a tiered-therapy, multiprogrammable antiarrhythmia device. Circulation 1992, 85:1689–1698.

    PubMed  CAS  Google Scholar 

  27. Sperry RE, Stabler BS, Cycan A, et al.: Has antiarrhythmic drug use declined in patients receiving implantable cardioverter defibrillators (ICDs) [abstract]? J Am Coll Cardiol 1993, 21:155A.

    Google Scholar 

  28. Olatidoye AG, Aarons D, Juanteguy J, Veltri EP: Clinical outcome of patients with refractory ventricular tachycardia/ fibrillation treated with implantable cardioverter defibrillator and no concomitant antiarrhythmic drug therapy J Am Coll Cardiol. 1994, 1A–484A.

  29. Lavergne T, Daubert JC, Chauvin M, et al.: Preliminary clinical experience with the first dual chamber pacemaker defibrillator. PACE 1997, 20:182–188.

    PubMed  CAS  Google Scholar 

  30. Reiter MJ, Mann DE: Sensing and tachyarrhythmia detection problems in implantable cardioverter defibrillators. J Cardiovasc Electrophysiol 1996, 7:542 558.

    Article  PubMed  Google Scholar 

  31. Huang SK, Tan de Guzman WL, Chenarides JG, et al.: Effects of long-term amiodarone therapy on the defibrillation threshold and the rate of shocks of the implantable cardioverter-defibrillator. Am Heart J 1991, 122:720–727.

    Article  PubMed  CAS  Google Scholar 

  32. Kou WH, Kirsh MM, Bollin SF, et al.: Effect of antiarrhythmic drug therapy on the incidence of shocks in patients wh receive an implantable cardioverter defibrillator after a single episode of sustained ventricular tachycardia/fibrillation. PACE 1991, 14:1586–1592.

    PubMed  CAS  Google Scholar 

  33. Anderson JL, Karagounis LA, Roskelley M, et al.: Effect of prophylactic antiarrhythmic therapy on time to implantable cardioverter-defibrillator discharge in patients with ventricular tachyarrhythmias. Am J Cardiol 1994, 73:683–687.

    Article  PubMed  CAS  Google Scholar 

  34. Pacifico A, Hohnloser SH, Williams JH, et al., for the d,l-Sotalol Implantable Cardioverter-Defibrillator Study Group: Prevention of implantable-defibrillator shocks by treatment with sotalol. N Engl J Med 1999, 340:1855–1862. Results of the first prospective randomized trial of the use of d-l sotalol in ICD recipients.

    Article  PubMed  CAS  Google Scholar 

  35. Ellenbogen K, Luceri R, Dorian P, et al., and Phase I Clinical Investigators: Clinical evaluation of implantable cardioverter defibrillator (CD) function: Importance of data logging to assess device efficacy [abstract]. Circulation 1991, 84(Suppl II):II-426.

    Google Scholar 

  36. Dorian P, Fain ES, Davy JM, Winkle RA: Lidocaine causes a reversible concentration-dependent increase in defibrillation energy requirements. J Am Coll Cardiol 1986, 8:327–332.

    Article  PubMed  CAS  Google Scholar 

  37. Barold SS, McVernes R, Stokes K: Effects of drugs on pacing threshold in man and canines: old and new facts In New perspectives in cardiac pacing. Edited by Barold SS, Mugica J. Mount Kisco, NY: Futura Publishing; 1993:57–83.

    Google Scholar 

  38. Jung W, Manz M, Pizzulli L, et al.: Effects of chronic amiodarone therapy on defibrillation threshold in man. Am J Cardiol 1992, 70:1023–1027.

    Article  PubMed  CAS  Google Scholar 

  39. Dorian P, Wong M, David I, Feinedell C: Oral clofilium produces sustained lowering of defibrillation energy requirements in a canine model. Circulation 1991, 83:614–621.

    PubMed  CAS  Google Scholar 

  40. Hohnloser SH, Woosley RK: Drug therapy: Sotalol. N Engl J Med 1994, 331:31.

    Article  PubMed  CAS  Google Scholar 

  41. Wong M, Dorian P: d-l and d-sotalol decrease defibrillation energy requirements. PACE 1989, 12 1522–1529.

    Google Scholar 

  42. Johnson WD, Saedi SF, Kamath ML, et al.: Allopurinol lowers defibrillation thresholds [abstract]. J am Coll Cardiol 1994, 23:85A.

    Google Scholar 

  43. Li HG, Thakur RK, Zardini M, et al.: Ethanol increases the defibrillation thresholds in patients with implantabl defibrillators [abstract]. J Am Coll Cardiol 1993, 21:304A.

    Google Scholar 

  44. Benser ME, Huang Y, Walcott GA, et al.: Bolus administration of intrapericardial ibutilide: its dynamic effect on myocardial refractory period and defibrillation threshold [abstract]. J Am Coll Cardiol 1998, 31:514A.

    Article  Google Scholar 

  45. Qi X-Q, Newman D, Dorian P: Azimilide decreases defibrillation voltage requirements and increases spatial organization during ventricular fibrillation. J Intervent Cardiac Electrophysiol 1999, 3:61–67.

    Article  CAS  Google Scholar 

  46. Manz M, Jung W, Luderitz B: Interactions between drugs and devices: Experimental and clinical studies. Am Heart J 1994, 127(Suppl):978–984.

    Article  PubMed  CAS  Google Scholar 

  47. Senatore C, Coltorti F, Giordano B, et al.: Defibrillation threshold in patients with ICD and concomitant antiarrhythmic drug therapy [abstract]. PACE 1999, 22(II):803.

    Google Scholar 

  48. Fisher JD, Kim SG, Matos JA, Ostrow E: Comparative effectiveness of pacing techniques for termination of well-tolerated sustained ventricular tachycardia. PACE 1983, 6:915 920.

    Google Scholar 

  49. Naccarelli GV, Zipes DP, Rahilly GT, et al.: Influence of tachycardia cycle lengths and antiarrhythmic drugs on pacing termination and acceleration of ventricular tachycardia. Am Heart J 1983, 105:1–5.

    Article  PubMed  CAS  Google Scholar 

  50. Levine JH, Mellits ED, Baumgardner RA: Predictors of first discharge and subsequent survival in patients with automatic implantable cardioverter-defibrillators. Circulation 1991, 84:558–566.

    PubMed  CAS  Google Scholar 

  51. Kannel WB, Abbot RD, Savage DD, McNamara PM: Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Eng J Med 1982, 306:1018–1022.

    Article  CAS  Google Scholar 

  52. Wellens HJJ, Lau C-P, Luderitz B, et al.: Atrioverter: an implantable device for the treatment of atrial fibrillation. Circulation 1998, 98 1651–1656. First article reporting the clinical results of atrial defibrillation in patients with atrial arrhythmias.

    PubMed  CAS  Google Scholar 

  53. Bailin SJ, Sulke N, Swerdlow CD, for the Worldwide 7250 Jewel AF-Only Investigators: Clinical experience with a dual chamber implantable cardioverter defibrillator in patients with atrial fibrillation and flutter [abstract]. PACE 1999, 22(II):871.

    Google Scholar 

  54. Reuter DG, Kriplen MM, Hoyt RH, et al.: Early recurrence of atrial fibrillation with an implantable atrial defibrillator: incidence, clinical predictors and time course [abstract]. 71st Sci Session:I–191.

  55. Wharton M, Santini M: Treatment of spontaneous atrial tachyarrhythmias with the Medtronic 7250 Jewel AF: Worldwide clinical experience [abstract]. 71st Sci Session:I–190.

  56. Levy S, Lauribe P, Dolla E, et al.: A randomized comparison of external and internal cardioversion of chronic atrial fibrillation. Circulation 1992, 86:1415–1420.

    PubMed  CAS  Google Scholar 

  57. Alt E, Schmitt C, Ammer R, et al.: Initial experience with intracardiac atrial defibrillation in patients with chronic atrial fibrillation. Pacing Clin Electrophysiol 1994, 17:1067–1078.

    Article  PubMed  CAS  Google Scholar 

  58. Saksena S, Prakash A, Mongeon L, et al.: Clinical efficacy and safety of atrial defibrillation using biphasic shocks and current nonthoracotomy endocardial lead configurations. Am J Cardiol 1995, 76:913–921.

    Article  PubMed  CAS  Google Scholar 

  59. Murgatroyd FD, Slade AKB, Sopher M, et al.: Efficacy and tolerability of transvenous low energy cardioversion of paroxysmal atrial fibrillation in humans. J Am Coll Cardiol 1995, 25:1347–1353.

    Article  PubMed  CAS  Google Scholar 

  60. Levy S, Ricard P, Lau CP, et al.: Multicenter low energy transvenous atrial defibrillation (XAD) trial results in different subsets of atrial fibrillation. J Am Coll Cardiol 1997, 29:750–755.

    Article  PubMed  CAS  Google Scholar 

  61. Lok N-S, Lau C-P Tse HF, Ayers GM: Clinical shock tolerability and effect of different right atrial electrode locations on efficacy of low energy human transvenous atrial defibrillation using an implantable lead system. J Am Coll Cardiol 1997, 30:1324–1330.

    Article  PubMed  CAS  Google Scholar 

  62. Jung J, Heisel A, Fries R, Kollner V: Tolerability of internal lowenergy shock strengths currently needed for endocardial atrial cardioversion. Am J Cardiol 1997, 80:1489–1490.

    Article  PubMed  CAS  Google Scholar 

  63. Ammer R, Alt E, Ayers G, Schmitt C, et al.: Pain threshold for low energy intracardiac cardioversion of atrial fibrillation with low or no sedation. PACE 1996, 19:230–236

    Google Scholar 

  64. Tomassoni G, Newby KH, Kearney MM, et al.: Testing different biphasic waveforms and capacitances: effect on atrial defibrillation threshold and pain perception J Am Coll Cardiol 1996, 28:695–699.

    PubMed  CAS  Google Scholar 

  65. Rossi M, Lown B: The use of quinidine in cardioversion. Am J Cardiol 1967, 19:234 238.

    Article  PubMed  Google Scholar 

  66. Sodermark T, Edhag O, Sjogren A, et al.: Effect of quinidine on maintaining sinus rhythm after conversion of atrial fibrillation or flutter. A multicenter study from Stockholm. Br Heart J 1975, 37:486–492.

    PubMed  CAS  Google Scholar 

  67. Van Gelder IC, Crijns HJGM, Van Gilst WH, et al.: Effects of flecainide on the atrial defibrillation threshold. Am J Cardiol 1989, 63 112–114.

    Article  PubMed  Google Scholar 

  68. Prakash A, Edmonds P, Giorgberidze I, Holt P: Pharmacological priming before external DC cardioversion for atrial fibrillation [abstract]. PACE. 1996,

  69. Iskos D, Lurie KG, Adler SW, et al.: Effect of parenteral d-sotalol on transvenous atrial defibrillation threshold in a canine model of atrial defibrillation Am Heart J 1996, 132 116 119.

    Article  PubMed  Google Scholar 

  70. Bianconi L, Mennuni M, Lukic V, et al.: Effects of oral propafenone administration before electrical cardioversion of chronic atrial fibrillation: a placebo-controlled trial. J Am Coll Cardiol 1996, 28:700–706

    Article  PubMed  CAS  Google Scholar 

  71. Strickberger S, Labhasetwa V, Davis J, et al.: Reduced defibrillation thresholds with endocardial administration of artilide [abstract]. J Am Coll Cardiol 1996, 27:265A.

    Article  Google Scholar 

  72. Newby K, Waugh R, Hardee M, et al.: Amiodarone decreases defibrillation threshold in patients undergoing elective cardioversion for atrial defibrillation. Circulation 1996, 94:I-666.

    Google Scholar 

  73. Mongeon L, Hill M, Mehra R: Procainamide decreases atrial defibrillation requirements in sustained atrial fibrillation conditioned canines. Circulation 1996, 94:I–136 I-137.

    Google Scholar 

  74. Oral H, Souza JJ, Michaud AF, et al.: Facilitating transthoracic cardioversion of atrial fibrillation with ibutilide pretreatment. N Eng J Med 1999, 340:1349–1354.

    Article  Google Scholar 

  75. Lai LP, Lin JL, Huang SKS: Sotalol decreases atrial defibrillation energy requirement in humans by increasing atrial refractory period but not by decreasing spatial dispersion of refractoriness: a bi-atrial basket mapping study [abstract]. 71st Sci Session (Suppl I):I–634.

  76. Boriani G, Biffi M, Capucci A, et al.: Atrial fibrillation: favorable effects of flecainide in transvenous low energy internal atrial cardioversion [abstract]. J Am Coll Cardiol 1998, 31(Suppl A) 196A.

    Article  Google Scholar 

  77. Natale A, Tomassoni G, Beheiry S, et al.: Effect of chronic administration of amiodarone on internal atrial defibrillation [abstract]. 71st Sci Sessions:I–711.

  78. Kumagai K, Yamanouchi T, Tashiro N, et al.: Low energy synchronous transcatheter cardioversion of atrial flutter/ fibrillation in the dog. J Am Coll Cardiol 1990, 16:497–501.

    Article  PubMed  CAS  Google Scholar 

  79. White JB, Fotuhi PC, Pedoto RW, et al.: reduction in atrial defibrillation threshold by radiofrequency ablation is caused by an increase in fibrillatory wavefront organization [abstract]. PACE 1999, 22(II):725.

    Google Scholar 

  80. Ott P, Arentz T, Blum T, et al.: of atrial fibrillation: effect of pre-shock RR interval [abstract]. J Am College Cardiol 1998, 31(Suppl A):332A.

    Article  Google Scholar 

  81. Saksena S, Prakash A, Krol RB, Shankar A: Regional endocardial mapping of spontaneous and induced atrial fibrillation in patients with heart disease and refractory atrial fibrillation. Am J Cardiol. 1999, in press.

  82. Saksena S, Shankar A, Prakash A, Krol RB: Catheter mapping of spontaneous and induced atrial fibrillation in man. J Intervent Cardiac Electrophysiol. 1999, 3(Suppl):in press.

  83. Giorgberidze I, Saksena S, Mongeon L, et al.: Effects of high frequency atrial pacing in atypical atrial flutter and atrial fibrillation. J Intervent Card Electrophys 1997, 1:111–123.

    Article  CAS  Google Scholar 

  84. Murgatroyd F, Slade A, Nitzsche R, et al.: A new pacing algorithm for the suppression of atrial fibrillation. PACE 1994, 17 863–867.

    Google Scholar 

  85. Reithmann C, Hoffmann E, Spitzlberger G, et al.: Catheter ablation of proarrhythmic atrial flutter due to amiodaron therapy for paroxysmal atrial fibrillation [abstract]. PACE 1999, 22(II):27.

    Google Scholar 

  86. Nabar A, Rodriquez LM, Timmermans C, et al.: Radiofrequenc ablation of “class IC atrial flutter” in patients with resistant atrial fibrillation. Am J Cardiol 1999, 83 785–787.

    Article  PubMed  CAS  Google Scholar 

  87. Delfaut P, Saksena S, Prakash A, Krol RB: Long-term outcome of patients with drug-refractory atrial flutter and fibrillation after single and dual site right atrial pacing for arrhythmia prevention. J Am Coll Cardiol 1998, 32:1900–1908.

    Article  PubMed  CAS  Google Scholar 

  88. Prakash A, Krol RB, Saksena S, Sumar R: Ablation of coexisting atrial flutter elicited using an electrophysiologic strategy in atrial fibrillation improves drug efficacy [abstract]. PACE 1999, 22(II):743.

    Google Scholar 

  89. Prakash A, Krol RB, Saksena S, Sumar R: Ablation of coexisting atrial flutter elicited using an electrophysiologic strateg in atrial fibrillation improves drug efficacy in refractor patients. PACE. 1999, in press.

  90. Saksena S, Prakash A, Hill M, et al.: Prevention of recurrent atrial fibrillation with chronic dual site right atrial pacing. J Am Coll Cardiol 1996, 28 687–694.

    PubMed  CAS  Google Scholar 

  91. Huang DT, Monahan KM, Zimetbaum P, et al.: Hybrid pharmacologic and ablative therapy: a novel and effective approach for the management of atrial fibrillation. J Cardiovasc Electrophysiol, 1998:9:462 469. Review of the current status of single and combination therapies for atrial fibrillation.

    PubMed  Google Scholar 

  92. Saksena S, Delfaut P, Prakash A, et al.: How to pace to prevent atrial fibrillation. Proceedings from the International Meeting on Atrial Fibrillation: Evolving Concepts and New Therapeutic Strategies, Bologna, Italy, October 1997.12–14,

  93. Flaker GC, Blackshear JL, McBride R, et al., on behalf of The Stroke Prevention in Atrial Fibrillation Investigators: Antiarrhythmic drug therapy and cardiac mortality in atrial fibrillation. J Am Coll Cardiol 1992, 20:527–532.

    Article  PubMed  CAS  Google Scholar 

  94. Mongeon LR, Warman EN, Mehra R: One right atrial linear lesion decreases atrial defibrillation thresholds in a canine model of sustained atrial fibrillation [abstract]. PACE 1999, 22(II):755.

    Google Scholar 

  95. Kalman J, Olgin J, Karch M, et al.: Effect of right atrial linear lesions on atrial defibrillation threshold. Implications for 'hybrid therapy [abstract]. PACE 1996, 19(II):625.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 55 Essex Street, Suite 3-2, 07041, Millburn, NJ, USA

    Ryszard B. Krol MD, Sanjeev Saksena MD & Atul Prakash MD

Authors
  1. Ryszard B. Krol MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sanjeev Saksena MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Atul Prakash MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Krol, R.B., Saksena, S. & Prakash, A. Interactions of antiarrhythmic drugs with implantable defibrillator therapy for atrial and ventricular tachyarrhythmias. Curr Cardiol Rep 1, 282–288 (1999). https://doi.org/10.1007/s11886-999-0051-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11886-999-0051-7

Keywords

Search

Navigation