30-year-old male presents to the Emergency depament with complaint of palpitations. On ECG, irregularly irregular rhythm with broad complex tachycardia is seen. He is haemodynamically stable. Which pharmacotherapy is the best initial management option, if DC cardioversion is not available?
This is the case of Pre-excited Atrial fibrillation-Stable patient-Rx-Flecainide given Pre-excited Atrial fibrillation Due to accessory pathway -Slowing AVN conduction without slowing AP conduction - facilitate AP conduction- Rapidly | ventricular rate. ECG- Irregularly irregular rhythm Broad complex bizarre QRS Rx o C/I - AV nodal blocking agents - verapamil, diltiazem, beta blockers, adenosine, amiodarone In stable patients - Class I antiarrhythmic drugs (Procainamide, Flecainide, Propafenone) should be used In Unstable patients - TOC - Immediate DC cardioversion
IV adenosine
IV verapamil
Oral beta-blocker
IV flecainide
ECG and Arrhythmia 2