Hemodynamic and surface electrocardiographic effects of a new aqueous formulation of intravenous amiodarone.
Intravenous amiodarone is an effective antiarrhythmic agent. However, the standard formulation (Cordarone IV) frequently causes hypotension. Hemodynamic studies have attributed this adverse effect to the solvents employed. A newly developed aqueous formulation (Amio-Aqueous) lacks solvents and thus may not causes hypotension. This study evaluated the hemodynamic effects in a cardiac catheterization laboratory. Two boluses of 150-mg aqueous amiodarone were administered via a peripheral vein to 32 hemodynamically stable patients who underwent cardiac catheterization. Boluses were administered initially over 2 to 5 minutes and in the last 9 patients over 2 minutes. Hemodynamic evaluation was performed and 12-lead electrocardiograms were obtained at baseline, immediately after each bolus, and following 30 minutes of observation. No patient developed hypotension. There were no significant changes in systolic and diastolic blood pressure (BP) following the boluses. Compared with baseline, heart rate (HR) significantly decreased 5 minutes after the second bolus (73 +/- 12 vs 67 +/- 11 beats/min, p <0.05). Mean arterial BP increased (90 +/- 14 vs 100 +/- 16 mm Hg, p <0.05) and dp/dt decreased (1,599 +/- 645 vs 1,294 +/- 531 mm Hg/s p <0.05), whereas the PR, QT, and JT intervals increased (174 +/- 30 vs 182 +/- 33; 402 +/- 32 vs 424 +/- 35; 317 +/- 37 vs 336 +/- 32 ms, p <0.05, respectively) by the end of the 30-minute observation period. Amio-Aqueous possesses pharmacodynamic effects that have been attributed to amiodarone, whereas it lacks the hypotensive effect of the standard intravenous amiodarone formulation. Amio-Aqueous appears to be a safer alternative to Cordarone IV when rapid administration is indicated.
Gallik
Donna M
DM
West Los Angeles VA Medical Center, Los Angeles, California, USA.
Singer
Igor
I
Meissner
Marc D
MD
Molnar
Janos
J
Somberg
John C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000008:administration & dosage* / Q000097:blood; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000097:blood; D002318:Cardiovascular Diseases / Q000188:drug therapy; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D016277:Ventricular Function, Left / Q000187:drug effects
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone