[The amiodarone-beta blockers combination could represent an alternative treatment in patients at risk for sudden death in which a benefit from implantable defibrillators has not been clearly demonstrated].
The combination of amiodarone and beta-blockers appears superior to amiodarone alone in the prevention of sudden death. At present this combination can be proposed to patients at risk of sudden death in whom a beneficial effect of the implantable defibrillator has not been clearly demonstrated. Therefore, the patients who can be treated with this combination appear the following ones: patients with sustained ventricular tachycardia (VT) causing severe hemodynamic compromise and ejection fraction > 35%; patients with hemodynamically well-tolerated sustained VT; patients with ischemic heart disease, syncope of unknown cause and induction of VT or ventricular fibrillation (VF) during electrophysiologic study; patients with sustained VT or VF and age > 80 years; patients with left ventricular dysfunction, without history of sustained VT or VF, but with "symptomatic ventricular arrhythmias".
Alboni
Paolo
P
Divisione di Cardiologia e Centro Aritmologico, Ospedale Civile, Cento, FE. p.alboni@ausl.fe.it
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000638:Amiodarone / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D004359:Drug Therapy, Combination; D006439:Hemodynamics; D006801:Humans; D017202:Myocardial Ischemia / Q000188:drug therapy; D013575:Syncope / Q000188:drug therapy; D017180:Tachycardia, Ventricular / Q000150:complications / Q000188:drug therapy; D014693:Ventricular Fibrillation / Q000188:drug therapy
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D000638:Amiodarone