Document Detail

Concomitant amiodarone and the implantable cardioverter-defibrillator: is there a place?
MedLine Citation:
PMID:  8329797     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To discuss the controversy surrounding concomitant therapy with amiodarone and the implantable cardioverter-defibrillator (ICD). DATA SOURCES: A MEDLINE search identified English-language literature sources, including nonhuman studies. STUDY SELECTION: Studies included those that specifically addressed the use of amiodarone plus the ICD as well as reviews of the ICD. DATA EXTRACTION: Studies were evaluated for design, type of defibrillation electrode or defibrillator, method of defibrillation, amiodarone loading and maintenance dosages, duration of amiodarone therapy, and study endpoints. DATA SYNTHESIS: Because the ICD functions by delivering energy to depolarize a mass of myocardium, concomitant use of antiarrhythmic agents that elevate the defibrillation threshold (DFT) beyond an ICD's energy capability may adversely effect patient outcome. Amiodarone has been shown to both increase and decrease the DFT. Trials examining the use of amiodarone plus the ICD have not provided strong evidence that amiodarone will decrease the number of ICD discharges or favorably affect the mortality rate. Amiodarone is also expensive and toxic. Although the cost of the ICD is relatively high, continuing improvements in battery life will decrease long-term costs. CONCLUSIONS: Controlled trials are required to substantiate the improved survival rate with the ICD and to determine the role of antiarrhythmic agents in conjunction with the device. At present, there are no data to support the combination of amiodarone and an ICD in terms of improved quality or duration of life.
P L McCollam; J M Nappi
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  27     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-08-17     Completed Date:  1993-08-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  736-41     Citation Subset:  IM    
Department of Hospital Pharmacy Practice & Administration, College of Pharmacy, Medical University of South Carolina, Charleston 29425.
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MeSH Terms
Amiodarone / therapeutic use*
Combined Modality Therapy
Death, Sudden, Cardiac / prevention & control
Defibrillators, Implantable* / classification
Electric Countershock / methods*
Tachycardia, Ventricular / therapy
Ventricular Fibrillation / therapy
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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