What is the clinical evidence from this study?

Study design: Observational. Population: haemodynamically-tolerated sustained monomorphic ventricular tachycardia (n=41). Intervention: Intravenous amiodarone. Primary outcome: Pharmacological termination within 20 min (95% CI 7 to 29).

What does this research mean for the field?

Bolus dose intravenous amiodarone 300 mg is relatively ineffective for terminating haemodynamically-tolerated sustained monomorphic ventricular tachycardia, achieving termination in only 15% of patients within 20 minutes while causing haemodynamic destabilization requiring emergency cardioversion in 17%. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

December 21, 2007Emergency Medicine Journal

Intravenous amiodarone for the pharmacological termination of haemodynamically-tolerated sustained ventricular tachycardia: is bolus dose amiodarone an appropriate first-line treatment?

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Key result

Bolus dose intravenous amiodarone 300 mg terminated haemodynamically-tolerated sustained monomorphic VT in only 15% of patients within 20 minutes, with 17% requiring emergency cardioversion.

Why the study?

Does bolus dose intravenous amiodarone improve pharmacological termination rates in patients with haemodynamically-tolerated sustained monomorphic VT?

Population

41 consecutive emergency admissions with haemodynamically-tolerated sustained monomorphic ventricular…

Design

Case_series

Follow-up

1 hour

Authors

DTDavid R. TomlinsonUniversity of London PCPerumpillichira J. CherianHamilton Health Sciences TBTimothy R. BettsElectrophysiology

Discussion

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Implication

Amiodarone bolus shows limited efficacy in stable monomorphic VT; leaves open need for randomized comparisons of pharmacological options.

Study Design

Type

Observational (n=41)

Structured PICO

Does bolus dose intravenous amiodarone improve pharmacological termination rates in patients with haemodynamically-tolerated sustained monomorphic VT?

Population

41 consecutive emergency admissions with haemodynamically-tolerated sustained monomorphic ventricular tachycardia (VT), mean age 68 years, 35 men, majority (85%) with ischaemic heart disease and impaired left ventricular function.

Intervention

Bolus dose intravenous amiodarone 300 mg

Outcome

Pharmacological termination rates within 20 min and 1 h

Bolus dose intravenous amiodarone is relatively ineffective for acutely terminating haemodynamically-tolerated sustained monomorphic VT and carries a significant risk of haemodynamic destabilisation.

Limitations

Retrospective design

Cite This Study

Tomlinson et al. (2007) conducted an observational in haemodynamically-tolerated sustained monomorphic ventricular tachycardia (n=41). Intravenous amiodarone was evaluated on Pharmacological termination within 20 min (95% CI 7 to 29). Bolus dose intravenous amiodarone 300 mg terminated haemodynamically-tolerated sustained monomorphic VT in only 15% of patients within 20 minutes, with 17% requiring emergency cardioversion.

synapsesocial.com/papers/6a18e0bac9d74cf65281fbe4 https://doi.org/10.1136/emj.2007.051086

Topics

Ventricular arrhythmias

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Intravenous amiodarone for the pharmacological termination of haemodynamically-tolerated sustained ventricular tachycardia: is bolus dose amiodarone an appropriate first-line treatment?

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Topics

Intravenous amiodarone for the pharmacological termination of haemodynamically-tolerated sustained ventricular tachycardia: is bolus dose amiodarone an appropriate first-line treatment?

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

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