Amiodarone in atrial fibrillation

Oral amiodarone may be used in the prevention of recurrences of paroxysmal atrial fibrillation (AF) or in chronic AF following electrical cardioversion or for pharmacological cardioversion of AF. The use of amiodarone for rate control of AF is also discussed in this article. Recent reports have shown that low-dose amiodarone is effective in preventing recurrence following cardioversion, but there have been no long-term controlled or comparative studies to support this. Thus amiodarone is not recommended as a first-line drug for preventing recurrences of AF. Results on the use of amiodarone in the prevention of paroxysmal AF have been equivocal; this may be attributed to differences in defining paroxysmal AF. The use of low-dose amiodarone, alone or in combination with a class I agent, may be beneficial in patients with AF but long-term studies to determine the safety and efficacy of the drug are required.