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Recent Advances : Newer drugs (Ref. Hari. 18th ed., also!!!) 

  1. Dronedarone
    1. It is a drug , mainly for the indication of cardiac arrhythmias.
    2. It was an alternative to amiodarone for the treatment of atrial fibrillation and atrial flutter in people whose hearts have either returned to normal rhythm or who undergo drug therapy or electric shock treatment to maintain normal rhythm. 
    3. It is contraindicated in patients with NYHA Class IV heart failure, or NYHA Class II–III heart failure. 
  2. Vernakalant
    1. It is multi-channel blocker used for the treatment of atrial fibrillation.
    2. It prolongs the atrial effective refractory period and slows conduction over the atrioventricular node. It effective refractory period is unchanged.
    3. It does not change the QT interval on the ECG.
    4. It blocks IKur, IACh, and Ito. These currents play key roles in atrial repolarization, and their blockade accounts for the prolongation of atrial ERP.
    5. It has no effect on heart rate.
  1. Dysgeusia (disturbance of taste)              
  2. Sneezing
  3. Paresthesia                              
  4. Cough          
  5. Hypotension.
Recent Advances:
  1. An automated external defibrillator (AED) is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia (LQ 2012) in a patient, and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm.
  2. With simple audio and visual commands, AEDs are designed to be simple to use for the layman, and the use of AEDs is taught in many first aid, first responder, and basic life support (BLS) level CPR classes.
Indications for a permanent pacemaker
  1. Complete AV block (Stokes-Adams attacks, asymptomatic, congenital)
  2. Mobitz type II –Beta block
  3. Persistent AV block after anterior MI
  4. Symptomatic bradycardia (eg sick sinus syndrome)
  5. Drug-resistant tachyarrhythmias.
Complications of Pacemaker
  1. Pacemaker syndrome
    In single-chamber pacing, retrograde conduction to the atria, which then contract during ventricular systole. This leads to retrograde flow in pulmonary veins, and ↓cardiac output.
  2. Pacemaker tachycardia:
    In dual-chamber pacing, a short-circuit loop goes between the electrodes, causing an artificial WPW-like syndrome. Solution: single-chamber pacing.

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