Therapy and Prevention Arz
نویسنده
چکیده
Ninety-six patients with recurrent, drug-refractory tachyarrhythmias were treated with amiodarone for 8.0 + 7.5 months (range 1 day to 27 months): 77 for recurrent ventricular tachycardia or ventricular fibrillation (VT/VF), two for complex ventricular ectopy, and 17 for supraventricular tachyarrhythmias. The actuarial incidence of successful amiodarone therapy was 52 + 7% at 12 months and 28 + 9% at 24 months for patients with VT/VF. Neither patient with complex ventricular ectopy was successfully treated. Among the patients with supraventricular tachyarrhythmias, 64.7% were successfully treated for 7.7 + 7.6 months (range 1 to 22 months). Amiodarone toxicity occurred in 66 of 91 patients (72.5%) treated for more than 1 week. Fourteen patients had therapy-limiting toxicity. Of these 14, six had pulmonary toxicity, four had arrhythmia exacerbation, one had hepatitis, one had renal toxicity, one had rash, and one had erythema nodosum. The actuarial incidence of therapy-limiting side effects was 27 + 7% at 15 months. We conclude that amiodarone is useful in the treatment of refractory tachyarrhythmias but that the rate of efficacy in VT/VF is lower and the incidence of significant toxicity is higher than has Circulation 68, No. 1, 88-94, 1983. AMIODARONE, a benzofuran derivative structurally similar to thyroxine, is under investigation in the United States for treatment of supraventricular and ventricular tachyarrhythmias. Previous studies have stressed two major conclusions: amiodarone is extremely effective, even in patients with arrhythmias refractory to other drugs, and it has a very low incidence of significant toxicity.1 We report our experience with amiodarone in 96 patients who had recurrent arrhythmias previously refractory to drug therapy. Our results are at variance with both major conclusions of most previous studies.
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