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Amiodarone: a late comer
1Department of Medicine, University of Miami School of Medicine, FL 33101, USA.
Insights
Amiodarone effectively treats ventricular arrhythmias post-myocardial infarction and with congestive heart failure, showing a trend toward decreased sudden deaths without increased mortality. This antiarrhythmic agent is a valuable treatment option.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Ventricular arrhythmias post-myocardial infarction (MI) and in congestive heart failure (CHF) are serious conditions.
- Existing antiarrhythmic agents may have proarrhythmic effects or be associated with increased mortality.
- Amiodarone has a long history of use in Europe but is a more recent addition to US clinical practice.
Abstract:
Amiodarone is useful in the treatment of patients with ventricular arrhythmias after acute myocardial infarction and was equally useful when these arrhythmias were associated with CHF. Amiodarone prolongs repolarization and lowers heart rate, actions that are beneficial in treating symptomatic arrhythmias. The absence of proarrhythmic effects distinguishes amiodarone from other antiarrhythmic agents. No excess mortality was seen in any of the amiodarone trials, and in fact, a definite trend toward a decrease in the number of sudden deaths was noted. For many years, amiodarone has been the antiarrhythmic drug of choice in Europe. Only in recent years has this drug gained respectability in the United States. Amiodarone is truly a late comer to our shores.