Amiodarone therapy in patients implanted with cardioverter-defibrillator for life-threatening ventricular arrhythmias

Kazuhiro Satomi, Takashi Kurita, Seiji Takatsuki, Yasuhiro Yokoyama, Masaomi Chinushi, Naoya Tsuboi, Takashi Nitta, Morio Shoda, Hideo Mitamura

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Whether amiodarone can improve the patient's clinical outcome by reducing implantable cardioverter-defibrillator (ICD) therapy deliveries for ventricular tachycardia or fibrillation (VT/VF) has not been clearly evaluated. Methods and Results: A total of 507 patients with VT/VF due to organic heart disease who had ICDs implanted were enrolled in this study. The patients were divided into 3 groups: Amiodarone (n=247), Class I antiarrhythmic drug (n=103) and Control (n=157) groups, and the total cause mortality and arrhythmic event free survival rates were evaluated between the groups. The mean follow-up period was 38±27 months. The left ventricular ejection fraction was significantly decreased in the Amiodarone group (Amiodarone: 37±15%; Class I: 39±16%; Control: 44±17%). The mortality and arrhythmic events were significantly higher in the Class I group than the Amiodarone group (p<0.05), but there was no significant difference between the Amiodarone and Control groups (arrhythmic event free rate at 5 years: Amiodarone: 53%; Class I: 35%; Control: 48%; 5 year survival: 86%, 74% and 77%, respectively). Side effects from amiodarone were found in 12% of the patients, but no fatal events were observed. Conclusions: The present study could not demonstrate the benefit of amiodarone in ICD patients, probably due to a significant clinical bias exerted in selecting this drug.

Original languageEnglish
Pages (from-to)977-984
Number of pages8
JournalCirculation Journal
Volume70
Issue number8
DOIs
Publication statusPublished - 2006

Fingerprint

Defibrillators
Amiodarone
Cardiac Arrhythmias
Therapeutics
Implantable Defibrillators
Mortality
Anti-Arrhythmia Agents
Ventricular Fibrillation
Ventricular Tachycardia
Stroke Volume
Disease-Free Survival
Heart Diseases
Survival Rate
Control Groups
Survival

Keywords

  • Amiodarone
  • Implantable cardioverter-defibrillator
  • Prognosis
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Amiodarone therapy in patients implanted with cardioverter-defibrillator for life-threatening ventricular arrhythmias. / Satomi, Kazuhiro; Kurita, Takashi; Takatsuki, Seiji; Yokoyama, Yasuhiro; Chinushi, Masaomi; Tsuboi, Naoya; Nitta, Takashi; Shoda, Morio; Mitamura, Hideo.

In: Circulation Journal, Vol. 70, No. 8, 2006, p. 977-984.

Research output: Contribution to journalArticle

Satomi, K, Kurita, T, Takatsuki, S, Yokoyama, Y, Chinushi, M, Tsuboi, N, Nitta, T, Shoda, M & Mitamura, H 2006, 'Amiodarone therapy in patients implanted with cardioverter-defibrillator for life-threatening ventricular arrhythmias', Circulation Journal, vol. 70, no. 8, pp. 977-984. https://doi.org/10.1253/circj.70.977
Satomi, Kazuhiro ; Kurita, Takashi ; Takatsuki, Seiji ; Yokoyama, Yasuhiro ; Chinushi, Masaomi ; Tsuboi, Naoya ; Nitta, Takashi ; Shoda, Morio ; Mitamura, Hideo. / Amiodarone therapy in patients implanted with cardioverter-defibrillator for life-threatening ventricular arrhythmias. In: Circulation Journal. 2006 ; Vol. 70, No. 8. pp. 977-984.
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AB - Background: Whether amiodarone can improve the patient's clinical outcome by reducing implantable cardioverter-defibrillator (ICD) therapy deliveries for ventricular tachycardia or fibrillation (VT/VF) has not been clearly evaluated. Methods and Results: A total of 507 patients with VT/VF due to organic heart disease who had ICDs implanted were enrolled in this study. The patients were divided into 3 groups: Amiodarone (n=247), Class I antiarrhythmic drug (n=103) and Control (n=157) groups, and the total cause mortality and arrhythmic event free survival rates were evaluated between the groups. The mean follow-up period was 38±27 months. The left ventricular ejection fraction was significantly decreased in the Amiodarone group (Amiodarone: 37±15%; Class I: 39±16%; Control: 44±17%). The mortality and arrhythmic events were significantly higher in the Class I group than the Amiodarone group (p<0.05), but there was no significant difference between the Amiodarone and Control groups (arrhythmic event free rate at 5 years: Amiodarone: 53%; Class I: 35%; Control: 48%; 5 year survival: 86%, 74% and 77%, respectively). Side effects from amiodarone were found in 12% of the patients, but no fatal events were observed. Conclusions: The present study could not demonstrate the benefit of amiodarone in ICD patients, probably due to a significant clinical bias exerted in selecting this drug.

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