By Paul Henry / in , , /

You have less choices of selecting an antiarrhythmic
drug when you have certain heart conditions. First of all, if you have a very thick heart,
and it has to be pretty thick, most of the drugs
haven’t been proven safe there. Amiodarone is probably the only drug I feel
comfortable with there, so I don’t really use most of the
other drugs in that situation. If you have coronary artery disease — and
I don’t mean, and this is a problem, you know everyone now is into the era of I’m
going to go get a calcium scan, well, and you find a little calcium in your vessel — that’s not what we mean by
coronary artery disease, okay? Or, a huge swath of the population
will be labeled that way. I mean, you have had clinical coronary disease. The drugs that are considered safe there are
sotalol, dofetilide, dronedarone, amiodarone. They’re okay to use in that situation. If you have heart failure, you’re pretty much
looking at amiodarone. With some people, I’ll use dofetilide, but
mostly amiodarone.

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