Antiarrhythmic Therapy for Atrial Fibrillation

Antiarrhythmic therapy for atrial fibrillation comprises a broad range of medications that are used to prevent conversion from normal sinus rhythm to atrial fibrillation, as well as to control symptoms. These medications, although effective, require extensive monitoring and patient education. The antiarrhythmics most commonly used to maintain normal sinus rhythm in atrial fibrillation patients are the class IC agents flecainide and propafenone and the class III agents amiodarone, dronedarone, sotalol, and dofetilide. Recommended monitoring parameters include renal and hepatic function, drug interactions, QT prolongation, and exacerbation of heart failure. Patient education should include drug interactions, adverse effects, and recommendations for laboratory monitoring. Community pharmacists are in a unique position to provide guidance on these medications to patients and providers