0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Rapid Suppression of Spontaneous Ventricular Arrhythmias during Oral Amiodarone Loading

Soo G. Kim, MD; Michael M. Mannino, MD; Robert Chou, MD; Scott Roth, MD; James A. Roth, MD; Basavaraj Desai, MD; Kevin J. Ferrick, MD; and John D. Fisher, MD
[+] Article and Author Information

Requests for Reprints: Soo G. Kim, MD, Division of Cardiology, Montefiore Medical Center, 111 East 210 th Street, Bronx, NY 10467.

Current Authors Addresses: Drs. Kim, Mannino, J. A. Roth, Desai, Ferrick, and Fisher: Department of Medicine, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467.

Dr. S. Roth: Division of Cardiology, Long Island Jewish Medical Center, 270-05 76th Avenue, Room 2135, New Hyde Park, NY 11042.

Dr. Chou: Department of Medicine, Columbia-Presbyterian Medical Center, 622 West 168th Street, Box P.H. 62, New York, NY 10032.


© 1992 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1992;117(3):197-201. doi:10.7326/0003-4819-117-3-197
Text Size: A A A

Objective: To determine the time course of effects of amiodarone during an oral loading period.

Design: A prospective, nonrandomized study.

Setting: Arrhythmia referral center at a university hospital.

Patients: Fifty patients with refractory sustained ventricular tachycardia (n = 44) or ventricular fibrillation (n = 6) and frequent (≥ 30/h) ventricular premature complexes.

Intervention: Oral amiodarone, 1200 mg/d for 14 days and 400 mg/d thereafter.

Measurements: Ambulatory electrocardiographic monitorings, 12-lead electrocardiograms, and amiodarone blood levels on days 3, 5, 7, 9, 11, 13, and 28.

Results: Dramatic reductions of ventricular arrhythmias were noted during the first 72 hours of the therapy. Average ventricular premature complexes/h, couplets/h, and nonsustained ventricular tachycardias/24 h were 524 ± 1224/h, 16 ± 61/h, and 167 ± 611/24 h, respectively, at baseline, and reduced to 140 ± 243/h, 11 ± 50/h, and 33 ± 117/24 h, respectively, on day 3 (P < 0.05 for all). Subsequent reductions of ventricular arrhythmias from day 3 to day 13 were more gradual but were still significant (P < 0.05). A significant reduction of ventricular arrhythmias (≥ 70% reduction of ventricular premature complexes and ≥ 90% reduction of nonsustained ventricular tachycardias) was noted in 50% of patients on day 3, in 65% on day 7, and in 83% on day 13. Prolongation of the QT interval exhibited a similar time course. There were no further differences in reduction of ventricular premature complexes or QT intervals between day 13 and day 28.

Conclusions: Oral amiodarone given in loading doses produces rapid and dramatic reductions in spontaneous ventricular arrhythmias within 72 hours. Subsequent reductions of spontaneous arrhythmia were gradual and less dramatic.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Topic Collections

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)