Effect of amiodarone on sinus node function in patients with sick sinus syndrome
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Clinical Cardiology
|August 1, 1987
Insights
Amiodarone
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Sick sinus syndrome (SSS) presents with symptomatic tachyarrhythmias.
- Dual-chamber pacemakers are often used in managing SSS.
- Amiodarone is an antiarrhythmic drug used for tachyarrhythmias.
Purpose of the Study:
- To investigate the impact of oral amiodarone on sinus node function in patients with documented sick sinus syndrome.
- To determine if amiodarone affects sinus node recovery time and intrinsic heart rate.
Main Methods:
- Nine patients with symptomatic sick sinus syndrome and pacemakers underwent Holter-ECG monitoring.
- Pacemaker inhibition assessed sinus node activity before and after four weeks of oral amiodarone.
- Sinus node function was evaluated by measuring recovery time and heart rate.
Main Results:
- Amiodarone did not alter sinus node function in 5 out of 9 patients.
- Severe depression of sinus node function was observed in 4 patients after amiodarone treatment.
- The drug's effect on sinus node function was variable among patients.
Conclusions:
- Amiodarone's safety in sick sinus syndrome patients with tachyarrhythmias is not universal.
- Concomitant pacemaker use is crucial for patients with sick sinus syndrome treated with amiodarone.
- Risk stratification is necessary to identify patients who may experience adverse effects on sinus node function.
Abstract:
The effect of amiodarone on sinus node function has been studied in 9 patients with symptomatic sick sinus node as documented by Holter-ECG. All patients had programmable dual-chamber pacemakers. Sinus node activity was assessed by intermittently inhibiting the pacemakers before and after four weeks of oral amiodarone treatment. Sinus node function was not altered by amiodarone in 5 patients but was severely depressed in 4 patients. Thus, it is concluded that amiodarone cannot be used safely in all patients with the tachybrady syndrome for the treatment of symptomatic tachyarrhythmias without concomitant pacing.