Great Interview with Dr. Luigi Di Biase

[www.medscape.com]

Travis

Very interesting talk.. I was surprised to hear him talk about Amiodarone as his drug of choice and no mention of flecainide which I was taking as PIP until recently.

Am I missing something?

Hi JoyWin, I think you misheard Dr Dibiase ... for the right patient he may use Amiodarone in temporary circumstances as he noted. but it is not Dr DiBiase's overall drug of choice. Only when an EP has the right patient for the AMIO and needs the gold standard of AAR drug therapy will most expert EPs even use AMIO and in most cases only for as short a period as is necessary.

And always a smart and experienced EP like Dr DiBiase will be highly cognizant that AMIO also carries the most risk of potentially serious side effects .. even death .. among the AAR drug family.

Shannon

Thanks...you're right.

Just listened to it again.

On amio, I was rock climbing with a friend who is a pediatrician. We talked about heart rhythm issues. She mentioned using amio on a 3 month old. I told her I was really surprised since it can be a nasty med. Basically it came down to they could not get the heart in rhythm any other way. I asked about thyroid & amio, she said that was easy to replace - I look askance at her!! She was also talking about kids with WPW (Wolfe Parkinson White) illness - multiple pathways in the AV node. Said they tried to get them to age 4 as that was when their blood vessels were large enough to get an ablating catheter in them.

Prior to this, I'd never thought about really young kids having rhythm issues!

George

Yikes regarding having to resort to amio for a 4 yr old.. I wonder if she knows about remote magnetic ablation for the kid. That would be the only way to do it for hard to navigate hearts. It is the standard of care for ablating congenital hearts as well. Success rate is high with low complication rates but need referral to specialized center with the system and dedicated pediatric EP ablation specialists. Or perhaps she knows about it but somehow the kid still needs to grow more before any attempts. But the amio scares me for such a young kid.