Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA

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Defibrillators are only so good at converting these arrhythmias and the more you have the more you're sort of rolling the dice that one of the episodes might not be successful, or that it will be electrically successful, and the patient will be converted into a paced or sinus rhythm but have pulseless electrical activity, which we've all seen when we've done codes on the floors and things. I guess Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA would be the you got to keep me focus of choice in this patient.

Just to review that, I think the salient points, younger Meningococcal Group B Vaccine (Trumenba )- FDA man, non-ischemic, dilated cardiomyopathy.

We tend to not use the class Ic drugs, flecainide, propafenone, in structural heart disease. When there's scar, and certainly in ischemic cardiomyopathy patients, these are no-no drugs. They have been shown Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA increase sudden death events in those patients, so we're not going to use those.

It leaves, really, the class 3 agents, so we've got amiodarone, sotalol, and potentially dofetilide, which also Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA an indication in this setting if the patient's not in active heart failure.

Sotalol and dofetilide both require a fairly normal QT interval, and a corrected QT interval specifically, about 440 or 450 at max. Dexlidk can be a little bit challenging if the patient's QRS is already widened, either because they have an underlying bundle branch block or they're paced, so there are kind of back-of-the-napkin corrections for this and they all kind of do it in a similar way where you're essentially accounting for the excess depolarization time, the excess QRS width, and subtracting it Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA some form from the QT interval.

A lot of patients with cardiomyopathy have long QT and it makes Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA two drugs drugs we can't use, and so that leaves amiodarone. Luckily that's usually hypothyroidism that we can treat, but can be hyperthyroidism, which is especially disconcerting in someone with ventricular arrhythmias, can lead to storm, and is not a good situation.

It can affect a lot of systems and so it is our drug of last resort, but frankly, I have quite a few patients on it to control the arrhythmias.

I think in this patient I would be hopeful that I could put them on sotalol. Delxido from antiarrhythmic drugs, something that you do a lot are Injrction)- for ventricular tachycardia. I'd be curious, kind of framed around the presentation for this type of patient, when do you consider referring this person for an ablation, performing an ablation.

Is it something that after their ofr event, since he's so young, just to avoid any toxicities from amiodarone if he's not a candidate for sotalol, just to go straight for an ablation and try to ablate these PVCs or the focus of origin. Or do we maybe make some modifications, see how things go, and if he continues to have more, then refer for an ablation.

I think this is excellent and you sort of stopped yourself, but I'm going to Injectioon)- out that you started to say, "Do you put him through an ablation. It's sort of my life's work to lower that barrier for the patients who would Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA, like Sodiium prior patient is a reasonable patient to go through a safe procedure.

This doesn't have to be a 9-hour slog or an unsafe procedure. That being said, this is a 60-year-old man with non-ischemic cardiomyopathy, and that is a very different animal. I focused a lot in the ischemic cardiomyopathy case oSdium there's substrate and that we're looking at substrate in relationship to the coronary artery disease and we know where the scarring is.

This particular patient, you haven't given us the details, but what do we actually know about his heart disease. The heart failure specialists really are moving away from that term "non-ischemic cardiomyopathy. I'm often referred this kind Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA patient after they've had more events on antiarrhythmics. I don't think this is a patient who should go straight to the lab.

I think they should be on an antiarrhythmic Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA and the guidelines would support that for a non-ischemic etiology. But let's say he had ongoing episodes. I get referred these patients by my colleagues to do their ablation and I may be the first person who is saying, "Hey, wait a second. Have we ruled out sarcoidosis. Have we ruled out ARVC in this patient. This arrhythmogenic right ventricular cardiomyopathy really can be a biventricular process, and Sldium have we sent them Dexlido (Dexamethasone Sodium Phosphate for Injection)- FDA genetic testing and this is lamin cardiomyopathy, which has a very different prognosis.

I Dexliso get to diagnose Chagas disease every now and again, which is kind of a fun one, and that has a different trajectory. I like to step back smi say, "What is the underlying etiology. The reason is the ablation is just not as successful in this population as we'd like it to be. But it sounds like that the success rate and thereby the threshold for referring to ablation is different in patients with ischemic cardiomyopathy.

Our endpoints and understanding of that substrate and ability to map that substrate, which tends to be sub-endocardial in ischemic disease, it's a lot easier to go about those ablations generally.

I keep using that word, but I mean scar, and that's really what we're generally targeting with ablation.

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