Efficacy and safety of intravenous amiodarone in recent-onset atrial fibrillation: experience in patients admitted to a general internal medicine department
Yitshak Kreiss, Yechezkel Sidi, Hanan Gur
Department of
Medicine C, the Chaim Sheba Medical Center, Tel Hashomer and The
Sackler Faculty of Medicine, Tel Aviv University, Israel
Correspondence to: Dr Hanan Gur, Department of Medicine C, Sheba Medical Center, Tel Hashomer 52621, Israel
Accepted 7 December 1998
We examined the efficacy and safety of intravenous
amiodarone in 20 unselected patients with recent-onset atrial
fibrillation who were admitted to a general internal medicine
department during a 6-month period. The treatment protocol included a
loading dose of 1200 mg intravenous amiodarone in 24 hours, after which
amiodarone treatment was continued orally. Eleven of the 20 patients
(55%) converted to sinus rhythm within 48 hours of intravenous
amiodarone treatment and were discharged in sinus rhythm, while 9/20
(45%) patients failed to convert during hospitalisation. Six patients (30%) failed to convert to sinus rhythm even after one further month
of oral treatment. There was one death and a high frequency (25%) of
thrombophlebitis during hospitalisation. The in-hospital non-convertors
had a significantly lower ejection fraction and initial low ventricular
response rate than the convertors. In conclusion, the acute conversion
rate by intravenous amiodarone was at best modest. It is suggested that
intravenous amiodarone is probably more effective in patients with
rapid recent-onset atrial fibrillation and good left ventricular function.
Keywords: amiodarone; atrial fibrillation
© 1999 by The Fellowship of Postgraduate Medicine
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