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Electrical cardioversion after amiodarone administration
J Sagristà-Sauleda1, G Permanyer-Miralda, J Soler-Soler
1Servicio de Cardiologia, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
Insights
Electrical cardioversion for supraventricular arrhythmias is safe in patients on amiodarone therapy. This study found that while amiodarone may increase ventricular premature beats, standard precautions ensure safe electrical cardioversion.
Area of Science:
- Cardiology
- Pharmacology
Background:
- The impact of amiodarone on electrical cardioversion for supraventricular tachyarrhythmias remains unclear.
- Amiodarone is frequently used for long-term management of arrhythmias.
Purpose of the Study:
- To evaluate the efficacy and safety of electrical cardioversion in patients undergoing amiodarone therapy.
- To assess potential complications associated with amiodarone use during cardioversion.
Main Methods:
- 130 electrical cardioversions were performed on patients on long-term oral amiodarone (Group I).
- 44 electrical cardioversions were performed on patients receiving intravenous amiodarone infusions (Group II).
- Both groups had atrial fibrillation or flutter; Group I was compared to a control group of 100 cardioversions.
Main Results:
- Group I showed a higher incidence of ventricular premature beats compared to controls.
- One patient in Group I experienced severe bradycardia with asystole, which resolved.
- Group II exhibited increased sinus bradycardia and ventricular premature beats.
Conclusions:
- Electrical cardioversion for supraventricular arrhythmias is safe in patients on long-term oral or intravenous amiodarone.
- Standard precautions are essential for safe cardioversion in this patient population.
- Amiodarone may increase the occurrence of certain arrhythmias during cardioversion but does not preclude the procedure.
Abstract:
The possible effect of amiodarone administration on the effectiveness and complications of electrical cardioversion of supraventricular tachyarrhythmias has not been properly assessed. To investigate the effects of amiodarone on cardioversion, we performed 130 electrical cardioversion procedures in 116 patients who were receiving long-term amiodarone therapy (group I) and 44 cardioversion procedures in 43 patients who were receiving intravenous infusions of amiodarone (group II). All patients in groups I and II had atrial fibrillation or flutter. In group I, there was a higher incidence of ventricular premature beats than in a control group of patients who underwent 100 cardioversions; one patient had severe bradycardia with asystole, which was resolved satisfactorily. In group II there was a higher incidence of sinus bradycardia and ventricular premature beats. It was concluded that electrical cardioversion of supraventricular arrhythmias can be safely performed in patients who are receiving long-term oral or intravenous amiodarone therapy if the usual precautions are observed.