Relationship between oral amiodarone and inappropriate therapy from an implantable cardioverter defibrillator.
BACKGROUND
This study evaluated the efficacy of amiodarone for avoiding inappropriate therapies by implantable cardioverter defibrillators (ICDs).


RESULTS
A total of 232 patients with structural heart disease (58+/-13 years; 78% males) who underwent an initial ICD implantation were retrospectively investigated to compare baseline characteristics and event rates of inappropriate ICD therapy delivery between patients with oral amiodarone therapy (amiodarone group, n=116) and those without (non-amiodarone group, n=116). During a mean follow-up of 29+/-21 months, inappropriate therapies occurred less frequently in the amiodarone group than in the non-amiodarone group (12% vs 27%, P=0.0068). As a cause of inappropriate ICD therapy, only atrial fibrillation (AF) significantly differed between the groups (3% vs 12%, P=0.01). The results of multivariate logistic regression analysis showed that amiodarone therapy (odds ratio (OR) 0.38, 95% confidence interval (CI) 0.19-0.77, P=0.0073) and no history of spontaneous AF (OR 0.27, 95%CI 0.13-0.57, P=0.0007) were independent predictors of a lower risk of inappropriate ICD therapy.


CONCLUSIONS
In the present group of ICD patients with structural heart disease, inappropriate therapy delivery occurred predominantly in those with spontaneous AF and/or without amiodarone.
Nagai
Takayuki
T
Department of Cardiovascular Medicine, National Cardiovascular Center, Suita, Japan.
Satomi
Kazuhiro
K
Noda
Takashi
T
Okamura
Hideo
H
Yamada
Yuko
Y
Shimizu
Wataru
W
Suyama
Kazuhiro
K
Aihara
Naohiko
N
Kamakura
Shiro
S
Kurita
Takashi
T
D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage*; D001281:Atrial Fibrillation; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D005260:Female; D006331:Heart Diseases / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure
D000638:Amiodarone