Amiodarone as treatment for atrial tachycardias after surgery

Atrial flutter, including all types of postoperative atrial tachycardias, is the one with the highest risk of late sudden death. Thus, late postoperative atrial tachycardias must be suppressed and all patients should be permanently treated after a first episode of atrial flutter. Daily oral doses of 200-250 mg/m2 amiodarone were found to be highly effective and well tolerated in young patients. However, in older patients and after long-term therapy, its use is restricted by adverse side-effects. In these cases, association of lower doses of antiarrhythmic agents, including amiodarone, may be effective and well tolerated. The use of other therapeutic options such as radiofrequency ablation should also be considered in older patients having drug-refractory postoperative atrial flutter.