Evidence-Based Analysis of Amiodarone Efficacy and Safety

Connolly, Stuart J.

doi:10.1161/01.cir.100.19.2025

Cited by 271 publications

(204 citation statements)

References 113 publications

(114 reference statements)

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“…22 Therefore, the issue of long-term safety of amiodarone identified in the guidelines 5 appears to be of less concern with clinicians in light of their level of prescribing. Amiodarone is a complex drug with multiple electrophysiologic effects, unusual pharmacokinetics, and numerous potentially harmful drug interactions and adverse effects.…”

Section: Guidelines Versus Clinical Practice: Why the Difference?mentioning

confidence: 99%

“…23,24 The prevalence of adverse effects has been reported to be as high as 15% in the first year of use and up to 50% during long-term use, even at low doses. 5,[22][23][24][25] Clinically significant extracardiac adverse effects, particularly with long-term use, include pulmonary and liver toxicity, hyper-and hypothyroidism, photosensitivity, neuropathy, blindness, and a blue discoloration of the skin. None of these occur with the class IC agents flecainide and propafenone, or with sotalol and dofetilide.…”

Section: Guidelines Versus Clinical Practice: Why the Difference?mentioning

confidence: 99%

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Antiarrhythmic drug therapy for atrial fibrillation: Are the guidelines guiding clinical practice?

Reiffel

Naccarelli

2006

Clin Cardiol

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Summary:The AFFIRM study showed no clear survival advantage for a rhythm versus rate control strategy in patients with atrial fibrillation (AF). However, rhythm control with antiarrhythmic drugs (AADs) is appropriate in a large number of patients with AF. The American College of Cardiology/ American Heart Association/European Society of Cardiology AF management guidelines include a safety-based algorithm for selection of AAD therapy. Class 1C agents are recommended as first-line therapy in patients without or with minimal structural heart disease. However, market research and clinical study data indicate a growing use of class III agents (mainly amiodarone) despite long-term safety and tolerability concerns, suggesting that clinical practice does not adhere to current guidelines.

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Section: Guidelines Versus Clinical Practice: Why the Difference?mentioning

confidence: 99%

Section: Guidelines Versus Clinical Practice: Why the Difference?mentioning

confidence: 99%

Antiarrhythmic drug therapy for atrial fibrillation: Are the guidelines guiding clinical practice?

Reiffel

Naccarelli

2006

Clin Cardiol

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“…Previous studies have suggested that AMD prevents the recurrence of VT, VF and unexpected death, and reduces the total mortality in patients with ventricular tachyarrhythmias. [17][18][19][20] These studies indicate AMD may be effective as an adjunct to ICD therapy to reduce the number of shocks.…”

Section: Figure 1 Cumulative Probability For the 2 Treatment Groupsmentioning

confidence: 99%

Efficacy of Additional Amiodarone Therapy in Patients with an Implantable Cardioverter‐Defibrillator

Matsumoto

Kumagai

Ogawa

et al. 2010

Journal of Arrhythmia

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Introduction: We examined whether the additional use of amiodarone (AMD) under implantable cardioverter-defibrillator (ICD) therapy may have beneficial effects in patients at risk for lethal ventricular arrhythmias with structural heart diseases.Methods: Sixty patients (47 males, mean age, 62 AE 13 years) with structural heart disease who underwent ICD implantation were retrospectively analyzed. There were 2 groups: one group (AMD group) was treated with AMD (n ¼ 33) and the other group (non-AMD group) was treated without AMD (n ¼ 27). We compared the incidence and appropriateness of ICD shock therapy between two groups.Results: During a mean follow-up of 28 AE 17 months, we identified a total of 62 episodes in 18 patients (30%) who received ICD shock therapy. ICD shock episodes were significantly less frequent in AMD group than in non-AMD group (15% versus 48%, P < 0:01), while inappropriate shock episodes were greater in non-AMD group than in AMD group (49% versus 4%, P ¼ 0:03). In cumulative probability of shock events, the risk of events was significantly lower in AMD group (P ¼ 0:007). Of 4 patients who died in AMD group, we observed one fatal pulmonary fibrosis.Conclusions: Additional AMD therapy in patients with an ICD may be effective in reducing the risk of shock discharge. (J Arrhythmia 2010; 26: 103-110)

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“…To date, it is considered to be the best and the most widely used AAD [1,4]. AM is particularly applicable in pharmacological control of AF, especially the maintenance of primary prevention of AF or conversion of AF to sinus rhythm [5]. Its use is not without a number of side effects such as severe toxicity of lung, liver, nerves, skin, and thyroid [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Wyniki profilaktycznej terapii radiojodem u chorych w stanie eutyreozy z nadczynnością tarczycy w wywiadzie przed podaniem amiodaronu z utrwalonym migotaniem przedsionków — badanie wstępne

Czarnywojtek¹,

Zgorzalewicz-Stachowiak²,

Woliński³

et al. 2014

Endokrynologia Polska

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Introduction: Radioiodine (RAI) therapy is a standard procedure in the treatment of hyperthyroidism. However, the use of RAI in euthyroid patients requiring chronic administration of amiodarone (AM) where other antiarrhythmic drugs may lack efficacy is still controversial. Objective: The aim of this study was to assess the safety and efficacy of an AM therapy prior to treatment with radioiodine therapy in euthyroid patients with permanent atrial fibrillation (PAF), who had been treated for hyperthyroidism in the past. Material and methods:This was a retrospective observational study. Patients were assessed at baseline and two, six, eight, and 12 months after RAI therapy. 17 euthyroid patients with PAF were qualified to the RAI (female/male 3/14; age range 65 to 87, median 71). The patients required chronic administration of AM as a prophylaxis against sudden death. Results: Each patient received an ablative dose of 800 MBq (22 mCi) of

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Evidence-Based Analysis of Amiodarone Efficacy and Safety

Cited by 271 publications

References 113 publications

Antiarrhythmic drug therapy for atrial fibrillation: Are the guidelines guiding clinical practice?

Antiarrhythmic drug therapy for atrial fibrillation: Are the guidelines guiding clinical practice?

Efficacy of Additional Amiodarone Therapy in Patients with an Implantable Cardioverter‐Defibrillator

Wyniki profilaktycznej terapii radiojodem u chorych w stanie eutyreozy z nadczynnością tarczycy w wywiadzie przed podaniem amiodaronu z utrwalonym migotaniem przedsionków — badanie wstępne

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