Clinical efficacy of long-term treatment with amiodarone for life-threatening arrhythmias

The present article reviews the experience with amiodarone therapy in life-threatening ventricular tachyarrhythmias. In 13 studies, 1,594 patients were treated with amiodarone in average doses of 300 mg/day. The mean annual death rate was 6.2%; the annual withdrawal rate averaged 8%. Risk factors for arrhythmia recurrence despite amiodarone therapy were low left ventricular ejection fraction, inducible ventricular tachycardia by programmed electrical stimulation or persisting ventricular tachycardia on Holter monitoring, and cardiac arrest before the institution of amiodarone therapy. In these patients, additional antiarrhythmic measures such as an automatic implantable cardioverter/defibrillator or other surgical interventions must be considered.