Efficacy and safety of short intravenous amiodarone in supraventricular tachyarrhythmias
Abstract
The safety and efficacy of short intravenous therapy with amiodarone were evaluated in 44 patients (24 males, 20 females), aged 21-84 years, with supraventricular tachyarrhythmias newly arisen in less than 24 hours. The study group consisted of 15 patients with paroxysmal supraventricular tachycardia, 8 patients with atrial flutter and 21 patients with atrial fibrillation. They were treated with a single infusion of amiodarone up to 2 hours after the restoration of a stable sinus rhythm, or up to a maximum dose of 2400 mg in 24 hours. Our study shows that 88.6% of all supraventricular tachyarrhythmias reverts to sinus rhythm in less than 24 hours: 100% of paroxysmal supraventricular tachycardia, 75% of atrial flutter, and 85.7% of atrial fibrillation. Intravenously administered amiodarone proves to take effect rapidly (0.5 to 22 hours). The plasma amiodarone concentrations at sinus rhythm restoration showed a wide range (405-3800 ng/ml). Piecewise analysis suggested that the probability of sinus rhythm was 14.4-fold greater in paroxysmal supraventricular tachycardia. No linear statistical relationship was detectable between the log-dose-body mass index and log-QTc. Total amiodarone dose and left atrial volume are inversely correlated with a statistically significant difference. The toxicity in our short intravenous course with amiodarone was not relevant. We conclude that short high-dose intravenous amiodarone shows efficacy and safety in all newly occurring supraventricular tachyarrhythmias.
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Amiodarone has been found effective for converting SVTs to sinus rhythm in many but mostly small nonrandomized trials.
“Although amiodarone has been found effective for conversion of SVTs to sinus rhythm in many but mostly very small and non-randomized trials, it should not be used as a first-line agent.80”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [80]
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- Authors
- Vietti-Ramus, G., Veglio, F., Marchisio, U., Burzio, P., & Latini, R.
- Affiliations
- Ospedale San Giovanni Bosco (IT)
- University of Turin (IT)
- Mario Negri Institute for Pharmacological Research (IT)
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1992-04
- Volume
- 35
- Issue
- 1
- Pages
- 77-85
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2023493040
- Cited by
- 36
- References
- 29
- Citations by year
- 2022: 2 · 2021: 1 · 2020: 1 · 2019: 2 · 2016: 5 · 2012: 1
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- amiodarone, intravenous amiodarone, supraventricular tachyarrhythmias, paroxysmal supraventricular tachycardia, atrial flutter, atrial fibrillation, sinus rhythm restoration, QTc prolongation, left atrial volume, drug toxicity
- MeSH terms
- Adult, Aged, Amiodarone, Arrhythmias, Cardiac, Atrial Fibrillation, Atrial Flutter, Dose-Response Relationship, Drug, Female, Humans, Infusions, Intravenous, Male, Middle Aged, Stroke Volume, Tachycardia, Paroxysmal, Tachycardia, Supraventricular
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