Effectiveness of amiodarone on ventricular arrhythmias during and after acute myocardial infarction

Hockings, B.; George, Thomas; Mahrous, Farouk; Taylor, Roger R.; Hajar, Hajar A.

doi:10.1016/0002-9149(87)90334-1

Cited by 48 publications

(9 citation statements)

References 13 publications

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“…Our results are at variance with the work of Hockings et al [11], who observed no benefit, despite reduction of arrhythmias, in patients with acute infarction treated with 600 mg of amiodarone by mouth and followed up to 9 months. It is obvious that amiodarone injected by vein has a more rapid effect, and its lowering action on peripheral resistance may be lost when administered per os.…”

Section: Discussioncontrasting

confidence: 99%

Intravenous amiodarone in acute anterior myocardial infarction: A controlled study

Greco

D'Alterio

Schiattarella

et al. 1989

Cardiovasc Drug Ther

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A randomized, single-blind controlled study intended to assess the potential benefits of intravenous amiodarone in anterior myocardial infarction is presented. Three hundred nineteen patients entered the study, 159 received amiodarone infusion, and 160 received glucose-insulin-potassium (GIK) infusion. Basal characteristics were similar in the two experimental groups, who were randomized on a consecutive basis. Exclusion criteria were shock or pulmonary edema, hypotension, inferoposterior infarction, bradycardia, antrioventricular block, severe diabetes, and other major diseases. Patients aged 27 to 70 years, with a Q-wave anterior infarction, initiated 12-40 hours earlier at the time of admission, entered the trial. Other entry criteria were heart rate higher than 80 beats/min and systolic blood pressure higher than 100 mmHg. Amiodarone was administered in saline infusion 10-20 mg/kg, within 4 to 10 hours, through a central vein. GIK infusion consisted of 150-300 g of glucose, 25-50 IU of insulin, and 80-120 mEq of KCl in 1000 cc of water at a rate of 1.5-2.0 ml/g/hour. Both groups received digitalis, nitrates, sedatives, and diuretics as needed. Although individually the major endpoints of death, reinfarction, and sustained supraventricular and ventricular arrhythmias did not differ significantly, each was less in the amiodarone group than in the control, and the sum of all adverse events was significantly lower for the amiodarone patients (p less than 001). Heart failure and conduction disturbances were not different in the two groups. This study shows that amiodarone, with its vasodilating and antiarrhythmic properties, may be beneficial in acute anterior infarction, but further studies on larger populations will be necessary in order to show a reduction of mortality rate.

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Section: Discussioncontrasting

confidence: 99%

Intravenous amiodarone in acute anterior myocardial infarction: A controlled study

Greco

D'Alterio

Schiattarella

et al. 1989

Cardiovasc Drug Ther

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“…In view of these results the focus switched to amiodarone, and to date there have been 13 randomised trials performed. [36][37][38][39][40][41][42][43][44][45][46][47][48] Only three of these have reported a significant reduction in overall mortality. [36][37][38] A meta-analysis of all 13 trials showed that there was a 13% reduction in mortality with amiodarone (p = 0.03) and a 29% reduction in arrhythmic death (p = 0.0003).…”

Section: Implantable Cardioverter Defibrillatorsmentioning

confidence: 99%

Device based treatment of heart failure

Patwala

Wright

2005

Postgraduate Medical Journal

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As the population ages and survival from ischaemic heart disease improves, the incidence and prevalence of congestive cardiac failure has increased dramatically. Medical treatments including ACE inhibitors, β blockers, and aldosterone antagonists have improved the outlook for most patients. However, despite optimal medical treatment there is a significant group of patients who continue to suffer poor morbidity and mortality. Device based treatment consisting of implantable cardioverter defibrillators (ICD) and cardiac resynchronisation therapy (CRT) devices offer new modes of treatment to patients with symptomatic heart failure despite optimal medical therapy. ICDs have been shown to reduce mortality in patients with severe heart failure while CRT leads to an improvement in functional class, quality of life scores, physiological measures such as peak vo 2, and reduce hospitalisations. Combination devices, which provide both ICD and CRT functions, have now been seen to provide synergistic benefits in selected patients.

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“…Fifteen randomized clinical trials (5864 patients), including six in post MI patients [32][33][34][35][36][37], were performed on amiodarone as a prophylaxis against SCD in moderate to high risk patients for SCD. Two meta-analyses [37,38] of these trials showed a 13 to 19% reduction in total mortality but the odds ratio was different based on the control group: the odds ratio for total mortality was lower in trials with "usual care" controls (odds ratio, 0.58; 95% CI, 0.41 to 0.83; P = .003) and in trials with active controls (odds ratio, 0.73; 95% CI, 0.43 to 1.25; P = .25) than in trials with placebo controls (odds ratio, 0.90; 95% CI, 0.76 to 1.06; P = .20).…”

Section: A: Empiric Amiodarone Therapymentioning

confidence: 99%

Can Amiodarone Prevent Sudden Cardiac Death in Patients with Hemodynamically Tolerated Sustained Ventricular Tachycardia and Coronary Artery Disease?

Arya

Haghjoo

Sadr‐Ameli

2005

Cardiovasc Drugs Ther

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One of the most important challenges in today's cardiology is prevention of sudden cardiac death in high risk patients with coronary artery disease (CAD). Sustained hemodynamically tolerated ventricular tachycardia (HTVT) comprises up to 30% of all cases of monomorphic ventricular tachycardia in patients with CAD. While there is a consensus on treatment of hemodynamically unstable sustained ventricular tachycardia in patients with CAD, some controversies regarding the proper treatment of HTVT exist. We re-examined existing clinical evidence, controversies and current guidelines on the treatment of HTVT in patients with CAD and demonstrated that compared to implantable cardioverter-defibrillator, amiodarone is not an acceptable therapeutic option in patients with ischemic heart disease who suffer from HTVT.

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Effectiveness of amiodarone on ventricular arrhythmias during and after acute myocardial infarction

Cited by 48 publications

References 13 publications

Intravenous amiodarone in acute anterior myocardial infarction: A controlled study

Intravenous amiodarone in acute anterior myocardial infarction: A controlled study

Device based treatment of heart failure

Can Amiodarone Prevent Sudden Cardiac Death in Patients with Hemodynamically Tolerated Sustained Ventricular Tachycardia and Coronary Artery Disease?

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