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Amiodarone: Maximising Survival Benefit with Empiric or Guided Therapy

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Review of available data suggests that serial drug testing in patients with a history of sustained ventricular tachyarrhythmias using various antiarrhythmic drugs including amiodarone is able to identify subgroups with favorable and unfavorable outcome (patient groups with suppression vs. no suppression of inducibility of VT/VF). These results more likely reflect patient selection rather than drug effects, thus limiting the role of electrophysiologically guided antiarrhythmic therapy to actively modify outcome. All major and actual antiarrhythmic drug trials including an amiodarone arm, have chosen to deliver this drug empirically in both patients with asymptomatic as well as severely symptomatic life-threatening sustained ventricular tachyarrhythmias instead of a guided approach. The empiric approach is therefore adequate until new valid data comparing the empiric with the guided—or the invasive with the non invasive—approach tell us otherwise.

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Authors and Affiliations

  1. Medical Hospital I, Klinikum Großhadern, University of Munich, München, Germany

    G. Steinbeck, U. Dorwarth & E. Hoffmann

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  1. G. Steinbeck
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  2. U. Dorwarth
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  3. E. Hoffmann
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Steinbeck, G., Dorwarth, U. & Hoffmann, E. Amiodarone: Maximising Survival Benefit with Empiric or Guided Therapy. J Interv Card Electrophysiol 4 (Suppl 1), 51–55 (2000). https://doi.org/10.1023/A:1009818229508

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