Intravenous dofetilide may be an effective rescue therapy for patients with atrial flutter and 1:1 AV conduction presenting with cardiogenic shock.
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May warrant consideration in refractory atrial flutter shock; leaves open confirmation in prospective studies.
Paroxysmal atrial flutter is a drug-resistant supraventricular tachyarrhythmia that is often accompanied by hemodynamic instability due to an excessive ventricular response. We report here a case of atrial flutter with 1:1 atrioventricular conduction, in which we were able to rescue the patient from a state of cardiogenic shock by using intravenous dofetilide, a new class III antiarrhythmic agent. Dofetilide was suitable for the treatment because it immediately increased atrioventricular nodal refractoriness without any negative inotropic action.
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Kuruma et al. (1996) studied this question.
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