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Serial lung function testing in patients treated with amiodarone: a prospective study.

I C Gleadhill1, R A Wise, S A Schonfeld

  • 1Johns Hopkins Hospital, Baltimore, Maryland.

The American Journal of Medicine
|January 1, 1989
PubMed
Summary
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Amiodarone pulmonary toxicity is rare, with lung function tests showing no accelerated decline in most patients. An isolated drop in diffusing capacity for carbon monoxide (DLCO) does not require stopping amiodarone if no toxicity is evident.

Area of Science:

  • Cardiology
  • Pulmonology
  • Pharmacology

Background:

  • Amiodarone is effective for cardiac arrhythmias but can cause pulmonary toxicity (2-15% incidence yearly).
  • Prospective study needed to assess amiodarone's effect on lung function in patients with refractory arrhythmias.

Purpose of the Study:

  • To prospectively evaluate serial lung function tests in patients treated with amiodarone.
  • To determine the impact of amiodarone on spirometry and diffusing capacity for carbon monoxide (DLCO).

Main Methods:

  • 91 patients with refractory cardiac arrhythmias treated with amiodarone.
  • Serial spirometry and DLCO measurements at baseline and up to 24 months (mean follow-up 351 days).

Main Results:

Related Experiment Videos

  • No accelerated decline in spirometric indices or DLCO in the overall cohort (mean dose 367 mg/day).
  • Elderly patients showed an accelerated DLCO decline (p<0.05); pre-existing lung disease and smokers did not.
  • 4.5% of patients developed clinical amiodarone pulmonary toxicity with >20% DLCO fall; all recovered after drug cessation.

    • Conclusions:

    • An isolated >20% fall in DLCO without clinical toxicity does not necessitate amiodarone discontinuation.
    • An unchanged DLCO is a reliable negative predictor of amiodarone-induced pulmonary toxicity.