Shocks from pacemaker cardioverter defibrillators increase with amiodarone in patients at high risk for sudden cardiac death.
The efficacy of amiodarone used in combination with a pacemaker cardioverter defibrillator (PCD) to decrease episodes of ventricular tachycardia and subsequent PCD shocks is not clear. We examined a retrospective registry of 82 patients with PCD implantation to define the efficacy of amiodarone treatment. We compared patients treated with amiodarone (for 24 consecutive months without interruption) versus no amiodarone. In patients treated with amiodarone there was a 3-fold increase (p = 0.02) in PCD shocks; in patients not on beta-blockers, amiodarone resulted in a 6-fold increase (p < 0.05) in PCD shocks. Patients with a left ventricular ejection fraction >30% on amiodarone and patients <72 years old had increases (p < 0.05) in PCD shocks. In conclusion, patients treated with amiodarone had more PCD shocks than those not treated. These findings are unexpected and merit a prospective study.
Shinde
Abhijit A
AA
Section of Cardiology, Department of Medicine, Southern Arizona VA Health Care System and Sarver Heart Center, University of Arizona, Tucson, AZ 85723, USA.
Juneman
Elizabeth B
EB
Mitchell
Brian
B
Pierce
Mary K
MK
Gaballa
Mohamed A
MA
Goldman
Steven
S
Thai
Hoang
H
D000368:Aged; D000638:Amiodarone / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010138:Pacemaker, Artificial; D011336:Probability; D012016:Reference Values; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000453:epidemiology / Q000209:etiology*; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*
D000638:Amiodarone