Effect of low-dose amiodarone on atrial fibrillation or flutter in Japanese patients with heart failure.
The efficacy and safety of amiodarone in the management of atrial fibrillation (AF) or flutter in 108 Japanese patients with heart failure was retrospectively examined. Thirty-four (41%) of the 82 patients who were in sinus rhythm after 1 month of amiodarone administration had their first recurrence, 70% of cases occurring within 1 year of initiation. The cumulative rates of maintenance of sinus rhythm were 0.68, 0.55, and 0.47 at 1, 3, and 5 years, respectively. Amiodarone was more effective in maintaining sinus rhythm in patients with paroxysmal AF or flutter than in those with the persistent form (p<0.05). The cumulative rates for cases that remained in permanent AF were 0.04, 0.11, and 0.14 at 1, 3, and 5 years, respectively. Apart from suppressing AF, the mean heart rate during Holter monitoring was significantly decreased with amiodarone therapy in cases of permanent AF. Adverse effects requiring the discontinuation of amiodarone therapy occurred in 16% of patients. Low-dose amiodarone therapy may prevent AF or flutter in Japanese patients with heart failure.
Shiga
Tsuyoshi
T
Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University. mshiga@hij.twmu.ac.jp
Wakaumi
Michi
M
Imai
Taku
T
Suzuki
Tsuyoshi
T
Hosaka
Fumitaka
F
Yamada
Yuichiro
Y
Matsuda
Naoki
N
Shoda
Mono
M
Sugiura
Ryo
R
Hagiwara
Nobuhisa
N
Kasanuki
Hiroshi
H
D000638:Amiodarone / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D001282:Atrial Flutter / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D002423:Cause of Death; D004077:Digoxin / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000145:classification / Q000150:complications; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000150:complications; D013997:Time Factors; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D004077:Digoxin; D000638:Amiodarone