Amiodarone - excellent antiarrhythmic drug? (Happy end after 40 years of problems)

Amiodarone, discovered forty years ago and in general use as an anti-anginal drug, has become a wide-spectrum anti-arrhythmic, used as the drug of preference in cardiac failure and after myocardial infarction, where it is the only drug (besides some betablockers) which does not increase overall mortality. It is successfully used in therapy and prophylaxis for life threatening arrhythmias, even when electro physiological testing has failed to disclose the detailed mechanism of arrhythmia. In cases of myocardial infarction it should be regarded as the anti-arrhythmic drug of first choice. Amiodarone is a drug which is capable with high probability of anticipating arrhythmias, combining, in an exclusive exceptional entity, beneficial effects on cardiac electrophysiology, neurochemical parameters, coronary flow and haemodynamics with a unique local antithyroid effect. A detailed survey of the current experimental and clinical basis for practical use is given, based on 93 cited sources from the last 30 years.