Quetiapine Use in Atrial Fibrillation Patients

Critical Safety Considerations and Management

• The American College of Cardiology recommends ensuring adequate rate control with beta-blockers or non-dihydropyridine calcium channel blockers, rather than amiodarone or sotalol, which would contraindicate quetiapine, and maintaining appropriate anticoagulation based on CHA₂DS₂-VASc score, as quetiapine does not affect stroke risk 1
• The American College of Cardiology suggests that rate-control agents, such as beta-blockers, diltiazem, and verapamil, are safer alternatives to rhythm-control antiarrhythmics, like amiodarone and sotalol, which are explicitly contraindicated with quetiapine due to additive QT prolongation 1

Drug Interactions and Precautions

• The American College of Cardiology advises against combining quetiapine with dofetilide, a pure Class III agent used for AF maintenance, due to unacceptable risk of additive QT prolongation 1