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For example, the discharge summary may list a calcium channel blocker that is not included in any of the other discharge medication sources (e.

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The clinical use of these drugs for AF is guided first by the risk of toxicity and then by efficacy ().

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SOTALOL (Sotalol hydrochloride) is indicated for the treatment of documented ventricular arrhythmias, such as sustained ventricular tachycardia, that in the judgment of the physician are life-threatening.

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Therefore, RF ablation is an option only if antiarrhythmic drugs fail in patients with persistent AF who remain severely symptomatic despite adequate ventricular rate control.

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The direct thrombin inhibitor dabigatran and the factor Xa inhibitor rivaroxaban are not recommended in patients with AF and end-stage CKD or on dialysis because of the lack of evidence from clinical trials regarding the balance of risks and benefits.

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ECG, ophthalmological examination, pulmonary function tests, chest x ray, thyroid function tests, and laboratory results (electrolytes, renal and liver function tests) carried out.

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Nonetheless, sotalol should be used with particular caution if the QT c is greater than 500 msec on-therapy and serious consideration should be given to reducing the dose or discontinuing therapy when the QT c exceeds 550 msec.

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Please refer to Appendix C in the full version of the original guideline document for full details on the study design of studies selected for each review question.

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Even with medications, there is a chance of another episode of atrial fibrillation.

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Patients in whom qualifying arrhythmias had occurred while they were receiving amiodarone at a daily dose of less than 300 mg were treated with a loading dose of 400 mg twice daily for 2 weeks, which was followed by 400 mg per day for 1 week and 300 mg per day thereafter.

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Another study, a meta-analysis involving more than 1000 patients, found that major bleeding complications were generally less critical and more manageable in patients being treated with dabigatran than in those on warfarin therapy.

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The main considerations specific to each recommendation are outlined in the "Recommendations and link to evidence" sections within each chapter.

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The results of the trial further suggested that switching to antiarrhythmic drugs may give the AF time to worsen.

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