G. Viettiramus et al., EFFICACY AND SAFETY OF SHORT INTRAVENOUS AMIODARONE IN SUPRAVENTRICULAR TACHYARRHYTHMIAS, International journal of cardiology, 35(1), 1992, pp. 77-85
The safety and efficacy of short intravenous therapy with amiodarone w
ere evaluated in 44 patients (24 males, 20 females), aged 21-84 years,
with supraventricular tachyarrhythmias newly arisen in less than 24 h
ours. The study group consisted of 15 patients with paroxysmal suprave
ntricular tachycardia, 8 patients with atrial flutter and 21 patients
with atrial fibrillation. They were treated with a single infusion of
amiodarone up to 2 hours after the restoration of a stable sinus rhyth
m, or up to a maximum dose of 2400 mg in 24 hours. Our study shows tha
t 88.6% of all supraventricular tachyarrhythmias reverts to sinus rhyt
hm in less than 24 hours: 100% of paroxysmal supraventricular tachycar
dia, 75% of atrial flutter, and 85.7% of atrial fibrillation. Intraven
ously administered amiodarone proves to take effect rapidly (0.5 to 22
hours). The plasma amiodarone concentrations at sinus rhythm restorat
ion showed a wide range (405-3800 ng/ml). Piecewise analysis suggested
that the probability of sinus rhythm was 14.4-fold greater in paroxys
mal supraventricular tachycardia. No linear statistical relationship w
as detectable between the log-dose-body mass index and log-QTc. Total
amiodarone dose and left atrial volume are inversely correlated with a
statistically significant difference. The toxicity in our short intra
venous course with amiodarone was not relevant. We conclude that short
high-dose intravenous amiodarone shows efficacy and safety in all new
ly occurring supraventricular tachyarrhythmias.