Title

Clinical efficacy of amiodarone.

Author

Nolan PE Jr; Nappi J; Pollak PT

Address

Department of Pharmacy Practice and Science, College of Pharmacy and Sarver Heart Center, University of Arizona, Tucson 85721-0207, USA.

Source

Pharmacotherapy, 18(6 Pt 2):127S-137S 1998 Nov-Dec

Abstract

OBJECTIVES: To review the clinical efficacy and role of amiodarone in the management of supraventricular and ventricular arrhythmias and its effects on mortality. METHODS: Review of relevant studies and reports. RESULTS: Amiodarone exerts significant effects on atrial tissue. In most studies it was completely or partly effective in preventing recurrences of atrial fibrillation or flutter in up to 80% of patients. Amiodarone may be superior to class Ia agents for maintaining normal sinus rhythm. Large randomized trials indicate that it is a potent suppressor of ventricular arrhythmia and reduces arrhythmic death after myocardial infarction. In patients with cardiomyopathy, it suppresses asymptomatic arrhythmias and increases left ventricular ejection fraction. Meta-analysis of relevant studies indicated that amiodarone reduces the risk of arrhythmic and sudden death by 29% in high-risk patients with recent myocardial infarction or congestive heart failure. This translates into an overall 13% reduction in total mortality. CONCLUSION: Because of its effectiveness against a broad range of arrhythmias, amiodarone is a valuable addition to the antiarrhythmic pharmacopeia.