Initiation of Class Ic Antiarrhythmic Medication and Monitoring of the Patient - Flowchart
Initiation of Class Ic Antiarrhythmic Medication and Monitoring of the Patient - Flowchart Initiation of Class Ic Antiarrhythmic Medication and Monitoring of the Patient Initiation of Class Ic Antiarrhythmic Medication and Monitoring of the Patient
«Flowchart»

Echocardiography
(Exercise stress test)

Echocardiography
(Exercise stress test)

Echocardiography
(Exercise stress test)

Echocardiography
(Exercise stress test)

Normal

Normal

Normal Normal

Abnormal

Abnormal

Abnormal Abnormal

Choose another drug


Sotalol?
Amiodarone?
Dronedarone?

Choose another drug


Sotalol?
Amiodarone?
Dronedarone?

Choose another drug

Choose another drug


Sotalol?
Amiodarone?
Dronedarone?


Sotalol? Sotalol?
Amiodarone? Amiodarone?
Dronedarone? Dronedarone?

End

End

End

Start treatment


Flecainide 100–200 mg/day
[Propafenone 450–600 mg/day]

Start treatment


Flecainide 100–200 mg/day
[Propafenone 450–600 mg/day]

Start treatment

Start treatment


Flecainide 100–200 mg/day
[Propafenone 450–600 mg/day]


Flecainide 100–200 mg/day
[Propafenone 450–600 mg/day] Flecainide 100–200 mg/day
[Propafenone 450–600 mg/day]

[Repeat the exercise stress test after the drug effect is stailized]

[Repeat the exercise stress test after the drug effect is stailized]

[Repeat the exercise stress test after the drug effect is stailized] [Repeat the exercise stress test after the drug effect is stailized]

Monitor the development of the situation regularly

Monitor the development of the situation regularly

Monitor the development of the situation regularly Monitor the development of the situation regularly

Monitor the development of the situation regularly

Monitor the development of the situation regularly

Monitor the development of the situation regularly

Monitor the development of the situation regularly

Symptoms or findings suggesting structural heart disease?

Symptoms or findings suggesting structural heart disease?

Symptoms or findings suggesting structural heart disease?

Symptoms or findings suggesting structural heart disease?

Yes

Yes

Yes Yes

No

No

No No

Normal

Normal

Normal Normal

Abnormal


QRS widens 40–50%
Abundant ventricular premature beats
Ventricular tachycardia
Ischaemia

Abnormal

Abnormal


QRS widens 40–50%
Abundant ventricular premature beats
Ventricular tachycardia
Ischaemia


QRS widens 40–50% QRS widens 40–50%
Abundant ventricular premature beats Abundant ventricular premature beats
Ventricular tachycardia Ventricular tachycardia
Ischaemia Ischaemia Abnormal