Intravenous amiodarone for ventricular arrhythmias: overview and clinical use

Numerous pharmacological agents with varying cellular electrophysiological effects are available to treat cardiac arrhythmias. Amiodarone is predomina ntly a Vaughan Williams Class III agent, but also possesses electrophysiolo gical characteristics of the other three Vaughan Williams classes (Class I and IV and minor Class II effects). Amiodarone's primary mechanism is to pr olong the cardiac action potential and repolarization time leading to an in creased refractory period and reduced membrane excitability. The efficacy a nd tolerability of intravenous (IV) amiodarone for acute treatment of recur rent and refractory ventricular tachycardia and ventricular fibrillation ha s been demonstrated in clinical trials. The ARREST trial, a randomized tria l comparing IV amiodarone to placebo, found a significant improvement in th e proportion of patients surviving to the emergency department following ou t-of-hospital cardiac arrest in amiodarone-treated patients. Intravenous am iodarone is an effective anti-arrhythmic agent for the acute treatment of l ife-threatening ventricular arrhythmias and represents an important treatme nt option for emergency anti-arrhythmic therapy for patients suffering from cardiac arrest. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved .