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Amiodarone therapy for atrial rhythm control: insights gained from a single center experience

Sheetal Chandhok1, David Schwartzman

  • 1Cardiovascular Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Journal of Cardiovascular Electrophysiology
|May 17, 2007
PubMed

Insights

Long-term amiodarone therapy for atrial fibrillation (AF) is not sustainable. After three years, only 45% of patients remained on amiodarone due to inefficacy, intolerance, or toxicity, including significant pulmonary issues.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Amiodarone is often recommended for long-term atrial fibrillation (AF) rhythm control.
  • The long-term sustainability of this therapeutic strategy requires further investigation.

Purpose of the Study:

  • To evaluate the long-term efficacy and tolerability of amiodarone for AF rhythm control.
  • To assess the rate of amiodarone cessation and its causes over a 3-year period.

Main Methods:

  • Retrospective analysis of 168 patients with symptomatic AF treated with amiodarone.
  • Evaluation of amiodarone cessation rates at 1, 2, and 3 years.
  • Categorization of cessation reasons: inefficacy, intolerance, or toxicity.

Main Results:

  • Only 45% of patients continued amiodarone therapy at 3 years.
  • Reasons for cessation included inefficacy (25%), intolerance (12%), and toxicity (18%).
  • Pulmonary toxicity occurred in at least 7% of patients.

Conclusions:

  • Amiodarone's long-term use for AF rhythm control is limited by cessation rates.
  • The study challenges amiodarone's role as a definitive "destination" therapy for AF.
  • Pulmonary toxicity is a significant concern with long-term amiodarone use.
Abstract

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