Key result
Amiodarone treatment in patients with a pacemaker cardioverter defibrillator was associated with a 3-fold increase in PCD shocks compared to no amiodarone (p=0.02).
Why the study?
Does amiodarone reduce pacemaker cardioverter defibrillator (PCD) shocks in patients with PCD implantation?
Observational (n=82)
Does amiodarone reduce pacemaker cardioverter defibrillator (PCD) shocks in patients with PCD implantation?
In patients with pacemaker cardioverter defibrillators, amiodarone therapy was unexpectedly associated with a significant increase in device shocks, highlighting the need for prospective evaluation.
Amiodarone was associated with more PCD shocks; leaves open causality versus confounding and supports prospective trials.
The efficacy of amiodarone used in combination with a pacemaker cardioverter defibrillator (PCD) to decrease episodes of ventricular tachycardia and subsequent PCD shocks is not clear. We examined a retrospective registry of 82 patients with PCD implantation to define the efficacy of amiodarone treatment. We compared patients treated with amiodarone (for 24 consecutive months without interruption) versus no amiodarone. In patients treated with amiodarone there was a 3-fold increase (p = 0.02) in PCD shocks; in patients not on beta-blockers, amiodarone resulted in a 6-fold increase (p < 0.05) in PCD shocks. Patients with a left ventricular ejection fraction >30% on amiodarone and patients <72 years old had increases (p < 0.05) in PCD shocks. In conclusion, patients treated with amiodarone had more PCD shocks than those not treated. These findings are unexpected and merit a prospective study.
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Shinde et al. (2003) conducted an observational in High risk for sudden cardiac death with pacemaker cardioverter defibrillator (n=82). Amiodarone vs. No amiodarone was evaluated on Pacemaker cardioverter defibrillator (PCD) shocks (3-fold increase, p=0.02). Amiodarone treatment in patients with a pacemaker cardioverter defibrillator was associated with a 3-fold increase in PCD shocks compared to no amiodarone (p=0.02).
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