To the Editors:

The article titled “Resource Utilization Related to Atrial Fibrillation After Coronary Artery Bypass Grafting” (May 2002:228–238) does not address the current standard of medical therapy for atrial fibrillation. The article was based on data collected from medical records from 1996 to 1998. Class III drugs such as amiodarone and ibutilide are the primary agents of choice in treating atrial fibrillation. Apothecon/procainamide hydrochloride are now considered to be proarrhythmic agents that can lead to ventricular tachycardia, ventricular fibrillation, and torsade des pointes. Numerous randomized clinical trials have supported the use of the class III agents as the best management approach for supraventricular tachycardias. Also, comprehensive electrolyte replacement therapy (potassium and magnesium scales intravenous and oral) are routine orders at my hospital, which was recommended as a target area for program development.

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