title: Amiodarone therapy in patients implanted with cardioverter-defibrillator for life-threatening ventricular arrhythmias.
abstract: 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.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Satomi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kurita
authors.forename: Seiji
authors.initials: S
authors.lastname: Takatsuki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Masaomi
authors.initials: M
authors.lastname: Chinushi
authors.forename: Naoya
authors.initials: N
authors.lastname: Tsuboi
authors.forename: Takashi
authors.initials: T
authors.lastname: Nitta
authors.forename: Morio
authors.initials: M
authors.lastname: Shoda
authors.forename: Hideo
authors.initials: H
authors.lastname: Mitamura
mesh_terms: 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
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D000638:Amiodarone