CHRONIC TREATMENT WITH AMIODARONE - EFFICACY AND SECONDARY EFFECTS

Long-term therapy with amiodarone has been associated with a high inci dence of adverse side effects, that precludes its indication for commo n cardiac arrhythmias We have prospectively studied 218 patients (pts) , aged 32-87 years, under chronic amiodarone theraphy that were follow ed for 2 years and evaluated for efficacy and adverse side effects. Pr evious amiodarone treatment ranged from 1 to 135 months. Cardiac arrhy thmias were paroxysmal AF (PAF) in 120 pts, sustained VT (SVT) in 36 p ts, paroxysmal supraventricular tachycardia (PSVT) in 21 pts, unsustai ned VT (UVT) in 18 pts and miscellaneous in 23 pts, Amiodarone doses r anged from 500 to 4200 mg per week Amiodarone was effective in 65% of all patients. No diference was observed between efficacy and type of a rrhythmia. Dermatologic toxicity was found in 36%, neurologic toxicity in 23%, thyroid toxicity in 13.4% and pulmonary fibrosis en 2.5% of p ts Amiodarone was discontinued routinely when pulmonary toxicity was p resent. We conclude that amiodarone therapy is effective in a wide spe ctrum of arrhythmias. Although drug theraphy was associated with a hig h incidence of adverse side effects, these did not preclude continuati on of treatment.