Amiodarone therapy for atrial rhythm control: insights gained from a single center experience.
BACKGROUND
Amiodarone has been advocated as an effective "long-term" therapy for atrial rhythm control in patients with atrial fibrillation (AF). We sought to assess the sustainability of this therapeutic strategy.


RESULTS
Retrospective analysis of a consecutive, single-center cohort (n = 168) with symptomatic AF who were treated with amiodarone and followed for 3 years. The incidence of amiodarone cessation was evaluated at 1, 2, and 3 years and attributed principally to drug inefficacy, intolerance, or toxicity. A gradual diminution in the number of patients on therapy was observed, such that by 3 years, only 45% remained. This was attributable to inefficacy (25%), intolerance (12%), or toxicity (18%). Pulmonary toxicity was surprisingly common, occurring in at least 7% of patients.


CONCLUSIONS
These data challenge the notion of amiodarone as a reasonable "destination" therapy for AF.
Chandhok
Sheetal
S
Cardiovascular Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Schwartzman
David
D
D000368:Aged; D000638:Amiodarone / Q000494:pharmacology / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology*; D016275:Atrial Function / Q000187:drug effects / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone