| Your
answer (B) is not the one that we are looking for! (C) is correct!
- Amiodarone is the most appropriate antiarrhythmic agent because it
has higher effectiveness in this setting and a very low propensity for
provoking a prorhythmic effect. Although adverse effects may occur,
they are usually dose related and less likely to occur at a dose of
200 mg/day.
- Flecainide is contraindicated because of the high risk of prorhythmias
with class 1C agents in the setting of impaired LV function and ischemic
heart disease.
- Sotalol should be avoided because of the severe LV dysfunction and
risk of prorhythmic effects.
- Quinidine and procainamide both have negative inotropic effects and
should also be avoided because of potential prorhythmic effects.
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