[Abnormal liver function during therapy with amiodarone in patients with persistent atrial fibrillation]

Area of Science:

• Cardiology
• Hepatology
• Pharmacology

Background:

• Atrial fibrillation is a common arrhythmia requiring pharmacologic management.
• Amiodarone is an effective antiarrhythmic drug but carries risks of liver toxicity.
• Liver function monitoring is crucial for patients on long-term amiodarone therapy.

Purpose of the Study:

• To determine the prevalence of liver function abnormalities in atrial fibrillation patients treated with amiodarone.
• To assess the impact of amiodarone on liver transaminase levels.
• To establish recommendations for monitoring liver function during amiodarone therapy.

Main Methods:

• A comparative study of two groups of atrial fibrillation patients.
• Group 1: Persistent atrial fibrillation treated with amiodarone for rhythm control (n=78).
• Group 2: Permanent atrial fibrillation treated with other agents for rate control (n=67).
• Liver transaminase activity and echography data were assessed after approximately 90 days of treatment.

Main Results:

• Asymptomatic elevation of liver transaminases was observed in 51.58% of patients in the amiodarone group.
• Pre-existing elevated liver transaminases exacerbated the increase during amiodarone treatment.
• No significant liver function changes were noted in the control group.

Conclusions:

• Continuous amiodarone use in atrial fibrillation patients necessitates regular liver function monitoring.
• Quarterly assessment of GGTP, AIAT, and AsAT is recommended.
• Significant liver enzyme elevation may warrant a change in treatment strategy, potentially to rate control therapy.