Efficacy and Safety of Intravenous Venous Amiodarone: A Single Center Experience

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Background: Efficacy and safety of intravenous amiodarone (IV-AMD) for Japanese patients in a real clinical practice have not been well evaluated. Methods and Results: Between Feb. 2008 and Feb. 2011, a total of 69 patients received IV-AMD in Kyoto University Hospital. Mean age was 67±17 years, and 46 (67%) were male. Sixty six patients (96%) had structural heart diseases, including ischemic heart diseases in 38 (55%), non-ischemic cardiomyopathies in 11 (16%), and valve diseases in 9 (13%). The target arrhythmias were ventricular tachyarrhythmias in 39 (56.5%), and atrial tachyarrhythmias in 30 (43.5%). IV-AMD was administered for a median duration of 2.0 (1–11) days, which was effective in 69% of patients with ventricular tachyarrhythmia and in 70% of patients with atrial tachyarrhythmia. Adverse effects requiring discontinuation of the drug occurred in 9 patients (13.0%); bradycardia in 4 (5.8%), low blood pressure in 2 (2.9%), QT prolongation in 2 (2.9%), and torsade de pointes in 1 (1.4%). There was no interstitial pneumonia or hypothyroidism. Conclusions: IV-AMD was effective for both ventricular and atrial tachyarrhythmia in approximately 70% of patients with structural heart diseases. Care should be taken for adverse effects, especially for bradycardia, hypotension and QT prolongation.