Clinical Efficacy of Amiodarone

Objectives. To review the clinical efficacy and role of amiodarone in the management of supraventricular and ventricular arrhythmias and its effects on mortality. Methods. Review of relevant studies and reports. Results. Amiodarone exerts significant effects on atrial tissue. In most studies it was completely or partly effective in preventing recurrences of atrial fibrillation or flutter in up to 80% of patients. Amiodarone may be superior to class Ia agents for maintaining normal sinus rhythm. Large randomized trials indicate that it is a potent suppressor of ventricular arrhythmia and reduces arrhythmic death after myocardial infarction. In patients with cardiomyopathy, it suppresses asymptomatic arrhythmias and increases left ventricular ejection fraction. Meta‐analysis of relevant studies indicated that amiodarone reduces the risk of arrhythmic and sudden death by 29% in high‐risk patients with recent myocardial infarction or congestive heart failure. This translates into an overall 13% reduction in total mortality. Conclusion. Because of its effectiveness against a broad range of arrhythmias, amiodarone is a valuable addition to the antiarrhythmic pharmacopeia.