Satomi K, Kurita T, Takatsuki S, Yokoyama Y, Chinushi M, Tsuboi N, Nitta T, Shoda M, Mitamura H. Amiodarone Therapy in Patients Implanted With Cardioverter-Defibrillator for Life-Threatening Ventricular Arrhythmias.
Circ J 2006;
70:977-84. [PMID:
16864928 DOI:
10.1253/circj.70.977]
[Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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.
METHODS AND 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%;
CONTROL
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%;
CONTROL
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.
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