Intravenous amiodarone for short-term treatment of refractory ventricular tachycardia or fibrillation

Intravenous amiodarone was administered to 22 patients with recurrent ventricular tachycardia failing an average of 3.0 prior antiarrhythmic agents after a mean of 14.6 cardioversions per patient. Patients received a mean bolus of 239 mg amiodarone, and a constant infusion of 0.5 to 1.0 mg/ml was administered over a mean of 50.7 hours. Hypotension requiring pressor agents was seen in nine patients and temporary pacing was needed in five patients. In the hospital, arrhythmic deaths occurred in two (9%) patients and nonarrhythmic deaths occurred in six (27%) patients. There were three late sudden deaths and three additional patients with appropriate automatic defibrillator discharges in follow-up. Intravenous amiodarone is very effective in preventing arrhythmic deaths in patients with refractory ventricular tachycardia and fibrillation.