Premium
Long‐Term Treatment of Ventricular Tachycardia with Amiodarone in Presence of Severe Left Ventricular Dysfunction
Author(s) -
Burckhardt Dieter,
Robertson Alan,
Hoffmann Andreas,
Pfisterer Matthias
Publication year - 1991
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1991.tb03679.x
Subject(s) - medicine , ejection fraction , amiodarone , cardiology , ventricular tachycardia , ventricular fibrillation , coronary artery disease , heart failure , sudden cardiac death , cardiomyopathy , dilated cardiomyopathy , atrial fibrillation
A group of 34 consecutive patients with coronary artery disease (n = 29) or dilated cardiomyopathy (n = 5) (3 women, 31 men, age 38–80 yr) who had severely impaired left ventricular function (left ventricular ejection fraction ≤ 40%) and high‐grade ventricular ectopic activity (sustained or nonsustained ventricular tachycardia or ventricular fibrillation) were treated with amiodarone (mean dose: 206 mg/d) and followed for 1–117 (mean: 49) months. In the total group, there were seven sudden deaths, five deaths due to pump failure, one non‐cardiac death, and two successful heart transplantations during follow‐up. Thus the annual cardiac mortality in these carefully selected and followed patients was 8, 6%, the annual cardiac event rate was 10, 1%. The cumulative cardiac survival‐rate was 62% after 5 years and 41% after 10 years. In jive patients, treatment was interrupted after 10 to 43 months, three of the patients were alive at follow‐up and two suffered cardiac death, resulting in an annual cardiac death rate of 12% in this subgroup off treatment. Based on the results of this retrospective analysis we conclude that in patients with low left ventricular ejection fraction and nonsustained or sustained ventricular tachycardia treated with low dose amiodarone, mortality was unexpectedly low. Thus, it may be the antiarrhythmic treatment to be considered in patients with ventricular tachycardia and severe left ventricular dysfunction.