Older agents have treatment limitations, including contraindications which prevent use in structural heart disease for some, proarrhythmia
or slow onset of action which may explain the need for longer hospital stays in others.
Beta-blockers can also be implicated if abruptly withdrawn preoperatively, leading to a postoperative sinus tachycardia and hypertension; postoperative use such as in coarctation repair may be associated with with bradycardia or AV block; or proarrhythmia
Dronedarone exhibited a favorable safety profile, most importantly with regard to its reassuringly low proarrhythmia
and the use of QTc prolonging agents: Clues for clinicians.
is observed in patients treated with drugs that block the hERG channel, including quinidine, dofetilide, antihistamines, and antibiotics (Bednar et al.
with class III antiarrhythmic drugs: types, risks, and management.
The Survival with Oral D-Sotalol Trial (16) tested the effect of D-sotalol, a sotalol isomer without a [beta]-blocking effect, and also demonstrated increased proarrhythmia
by the active drug.
These safety issues include risk of drug induced proarrhythmia
and other cardiac liabilities.
Clinical experience in an acute coronary syndrome population did not show an increased risk of proarrhythmia
or sudden death.
The potential for QT prolongation and proarrhythmia
by non-antiarrhythmic drugs: clinical and regulatory implications.
Dronedarone was well tolerated with no evidence of organ toxicity or proarrhythmia
over six months.
Therefore, the unmonitored use of quinolones is most likely safe and the risk of proarrhythmia
is low in patients who do not have other factors increasing their risk for QT interval prolongation.