Key result
Adding amiodarone to ICD therapy is linked to ~69% fewer shock episodes.
Why the study?
The potential beneficial effects of additional amiodarone therapy under ICD treatment in patients with structural heart disease at risk for lethal ventricular arrhythmias were unclear.
Does amiodarone reduce the incidence of ICD shock therapy in patients with structural heart disease and an ICD?
Cohort (n=60)
Does amiodarone reduce the incidence of ICD shock therapy in patients with structural heart disease and an ICD?
The addition of amiodarone to ICD therapy in patients with structural heart disease significantly reduces the risk of both overall and inappropriate shock discharges.
Amiodarone with ICD was associated with fewer events in this small retrospective cohort; leaves open benefit in structural heart disease without prospective confirmation.
Introduction: We examined whether the additional use of amiodarone (AMD) under implantable cardioverter‐defibrillator (ICD) therapy may have beneficial effects in patients at risk for lethal ventricular arrhythmias with structural heart diseases. Methods: Sixty patients (47 males, mean age, 62 ± 13 years) with structural heart disease who underwent ICD implantation were retrospectively analyzed. There were 2 groups: one group (AMD group) was treated with AMD (n = 33) and the other group (non‐AMD group) was treated without AMD (n = 27). We compared the incidence and appropriateness of ICD shock therapy between two groups. Results: During a mean follow‐up of 28 ± 17 months, we identified a total of 62 episodes in 18 patients (30%) who received ICD shock therapy. ICD shock episodes were significantly less frequent in AMD group than in non‐AMD group (15% versus 48%, P < 0.01), while inappropriate shock episodes were greater in non‐AMD group than in AMD group (49% versus 4%, P = 0.03). In cumulative probability of shock events, the risk of events was significantly lower in AMD group (P = 0.007). Of 4 patients who died in AMD group, we observed one fatal pulmonary fibrosis. Conclusions: Additional AMD therapy in patients with an ICD may be effective in reducing the risk of shock discharge.
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Matsumoto et al. (2010) conducted a cohort in Structural heart disease with an implantable cardioverter-defibrillator (n=60). Amiodarone vs. No amiodarone was evaluated on Incidence of ICD shock therapy (p=<0.01). Additional amiodarone therapy in patients with an ICD was associated with a significantly lower incidence of ICD shock episodes compared to no amiodarone (15% vs 48%, P<0.01).
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