Amiodarone therapy in patients implanted with cardioverter-defibrillator for life-threatening ventricular arrhythmias.
BACKGROUND
Whether amiodarone can improve the patient's clinical outcome by reducing implantable cardioverter-defibrillator (ICD) therapy deliveries for ventricular tachycardia or fibrillation (VT/VF) has not been clearly evaluated.


RESULTS
A total of 507 patients with VT/VF due to organic heart disease who had ICDs implanted were enrolled in this study. The patients were divided into 3 groups: Amiodarone (n=247), Class I anti-arrhythmic drug (n=103) and CONTROL (n=157) groups, and the total cause mortality and arrhythmic event free survival rates were evaluated between the groups. The mean follow-up period was 38+/-27 months. The left ventricular ejection fraction was significantly decreased in the Amiodarone group (Amiodarone: 37+/-15%; Class I: 39+/-16%;


METHODS
44+/-17%). The mortality and arrhythmic events were significantly higher in the Class I group than the Amiodarone group (p<0.05), but there was no significant difference between the Amiodarone and CONTROL groups (arrhythmic event free rate at 5 years: Amiodarone: 53%; Class I: 35%;


METHODS
48%; 5 year survival: 86%, 74% and 77%, respectively). Side effects from amiodarone were found in 12% of the patients, but no fatal events were observed.


CONCLUSIONS
The present study could not demonstrate the benefit of amiodarone in ICD patients, probably due to a significant clinical bias exerted in selecting this drug.
Satomi
Kazuhiro
K
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan.
Kurita
Takashi
T
Takatsuki
Seiji
S
Yokoyama
Yasuhiro
Y
Chinushi
Masaomi
M
Tsuboi
Naoya
N
Nitta
Takashi
T
Shoda
Morio
M
Mitamura
Hideo
H
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000503:physiopathology; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D018754:Ventricular Dysfunction / Q000188:drug therapy / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D000638:Amiodarone