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Intravenous amiodarone

P R Kowey1, R A Marinchak, S J Rials

  • 1Division of Cardiovascular Diseases, Lankenau Hospital and Medical Research Center, Wynnewood, Pennsylvania 19096, USA.

Journal of the American College of Cardiology
|May 1, 1997
PubMed
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Intravenous amiodarone effectively treats malignant ventricular arrhythmias, showing high suppression rates. This review details its pharmacology, efficacy, and safety for severe cardiac conditions.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Intravenous amiodarone, approved in 1995, is a complex antiarrhythmic drug.
  • Recent research has expanded understanding of its use in various cardiac arrhythmias.

Purpose of the Study:

  • To summarize current knowledge on intravenous amiodarone's pharmacology and electrophysiology.
  • To review its efficacy in treating malignant ventricular arrhythmias.
  • To provide clinical guidance for its use in various indications.

Main Methods:

  • Review of studies published between 1983 and 1995.
  • Inclusion of studies with detailed patient data, dosing, efficacy, follow-up, and complications.
  • Extensive review of data from three pivotal controlled trials.

Main Results:

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  • Demonstrable efficacy in treating recurrent ventricular tachycardia and fibrillation (63-91% suppression rates).
  • Pivotal trials confirmed efficacy and showed a dose-response relationship.
  • Comparable efficacy to bretylium for similar indications.
  • Cardiovascular adverse effects, particularly hypotension, are the most frequent safety concerns.

Conclusions:

  • Intravenous amiodarone is a valuable treatment for severe ventricular arrhythmias.
  • Its potential use in other rhythm disorders is promising but requires further data.
  • Ongoing clinical trials will provide more definitive recommendations.