Amiodarone is highly effective for severe tachyarrhythmias but its use is limited by significant toxicity and complex pharmacokinetics.
Supports selective use with vigilant monitoring in refractory cases; leaves open development of safer alternatives.
Amiodarone is the most effective antiarrhythmic drug available. In most countries (including Australia), amiodarone is the most commonly prescribed antiarrhythmic apart from drugs such as digoxin and beta blockers. Amiodarone can be used to treat tachyarrhythmias, including atrial fibrillation, ventricular tachycardia and patients at high risk of sudden cardiac death. Although amiodarone is effective, it is not generally recommended for minor rhythm disturbances because of its toxicity. It is a difficult and challenging drug to use in clinical practice. This is because of its very prolonged half-life and because of its multiple adverse effects.
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Terence J. Campbell (2005) studied this question.
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