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Amiodarone in atrial fibrillation
Abstract:
Twenty-seven patients with atrial fibrillation without any concomitant conduction abnormality have been treated with oral amiodarone in a daily maintenance dose of 200 mg. The drug has been used for three purposes: 1) to block atrioventricular conduction, thereby decreasing the ventricular rate during atrial fibrillation (9 patients), 2) as prophylaxis against paroxysmal atrial fibrillation (8 patients), 3) as prophylaxis against recurrence of atrial fibrillation after DC conversion to sinus rhythm (13 patients). All patients were considered refractory to other antiarrhythmic drugs in these respects. In the second group, 4 of the 8 patients reported complete cessation of attacks and the others a marked reduction of the attack rate. In the third group, 10 of the 13 patients have maintained sinus rhythm for a longer period on treatment with amiodarone than with other drugs, resulting more than a triple prolongation of the time in sinus rhythm. In 3 patients the drug has been discontinued because of side-effects. In conclusion, amiodarone affords protection from episodes of paroxysmal atrial fibrillation, as well as from recurrence of atrial fibrillation after DC conversion to sinus rhythm. If the drug is ineffective in either of these respects, it may still be useful as a means of moderating the ventricular response in atrial fibrillation.
Insights
Oral amiodarone effectively manages atrial fibrillation by preventing episodes and recurrence, and can also control ventricular rate. This study shows amiodarone
Area of Science:
- Cardiology
- Pharmacology
Background:
- Atrial fibrillation is a common arrhythmia.
- Patients often have refractory arrhythmias to existing treatments.
Purpose of the Study:
- To evaluate the efficacy of oral amiodarone in patients with atrial fibrillation.
- To assess amiodarone for rate control, paroxysmal atrial fibrillation prophylaxis, and post-conversion rhythm maintenance.
Main Methods:
- Oral amiodarone (200 mg daily) was administered to 27 patients.
- Patients were treated for rate control (9), paroxysmal AF prophylaxis (8), or post-DC conversion prophylaxis (13).
- Patients were refractory to other antiarrhythmic drugs.
Main Results:
- Amiodarone provided complete cessation or marked reduction in paroxysmal atrial fibrillation attacks in 8 patients.
- 10 of 13 patients maintained sinus rhythm longer with amiodarone after DC conversion.
- Amiodarone was effective in moderating ventricular response in atrial fibrillation for 9 patients.
- 3 patients discontinued treatment due to side effects.
Conclusions:
- Oral amiodarone is effective for preventing atrial fibrillation episodes and recurrence after cardioversion.
- Amiodarone serves as a valuable option for ventricular rate control when other treatments fail.