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Low-dose amiodarone in severe chronic heart failure
A Biswas1, S K Dey, A K Banerjee
1Department of Cardiology, Institute of Post Graduate Medical Education & Research, Calcutta.
Indian Heart Journal
|July 1, 1996
Summary
Low-dose amiodarone improved exercise tolerance in severe heart failure patients but did not reduce cardiac deaths. This antiarrhythmic drug showed efficacy but failed to meet expectations for preventing sudden cardiac death.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Sudden cardiac death is a significant cause of mortality in congestive heart failure patients.
- Asymptomatic ventricular arrhythmias are linked to increased mortality in this population.
Purpose of the Study:
- To assess the efficacy of low-dose amiodarone in reducing mortality in severe congestive heart failure.
- To evaluate amiodarone's effects on exercise tolerance, left ventricular systolic function, and ventricular ectopic activity.
Main Methods:
- Prospective, randomized, single-blind, placebo-controlled trial.
- Patients received amiodarone (400 mg/day then 200 mg/day) or standard treatment.
- Intention-to-treat analysis was used.
Main Results:
- 10 cardiac deaths in the amiodarone group vs. 16 in the control group.
- Significant improvement in exercise time (modified Bruce Protocol) in the amiodarone group.
- Side-effects included elevated hepatic enzymes (6%) and proarrhythmia (3%).
Conclusions:
- Low-dose amiodarone is an effective antiarrhythmic agent.
- It improved exercise tolerance in severe heart failure patients.
- It did not reduce sudden cardiac death in patients with asymptomatic ventricular ectopy.