Acute bolus intravenous amiodarone caused a 20% decrease in cardiac index in patients with left ventricular ejection fraction <0.35, whereas those with LVEF >0.35 had improved cardiac performance.
Observational
What are the hemodynamic effects of intravenous amiodarone in patients with varying baseline left ventricular ejection fractions?
Intravenous amiodarone can cause significant hemodynamic deterioration, including a 20% drop in cardiac index, in patients with preexisting left ventricular dysfunction.
Amiodarone is a potent antiarrhythmic agent that is effective in controlling both atrial and ventricular arrhythmias. Recently, intravenous administration was demonstrated to be effective in the acute management of rhythm disorders and, in addition, appeared to shorten the loading period normally required for oral drug administration. This investigation examined the hemodynamic effects of amiodarone after both acute intravenous bolus and continuous intravenous administration. Patients with a left ventricular ejection fraction greater than 0.35 experienced improved cardiac performance due to both acute and chronic peripheral vasodilation. However, patients with a lower ejection fraction developed a 20% decrease in cardiac index and clinically significant elevation of right heart pressures after acute bolus administration; these changes were variably compensated for by peripheral vasodilation when the drug was administered intravenously over 3 to 5 days continuously. Therefore, intravenous amiodarone can result in significant impairment of left ventricular performance in patients with preexisting left ventricular dysfunction.
Kosinski et al. (Sat,) conducted a observational in Arrhythmias. Intravenous amiodarone was evaluated on Hemodynamic effects (cardiac performance, cardiac index, right heart pressures). Acute bolus intravenous amiodarone caused a 20% decrease in cardiac index in patients with left ventricular ejection fraction <0.35, whereas those with LVEF >0.35 had improved cardiac performance.