Early outcome of initiating amiodarone for atrial fibrillation in advanced heart failure

Mark S. Weinfeld, Mark H. Drazner, William G. Stevenson, Lynne W. Stevenson

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Background: Little information exists about the early outcomes of initiating amiodarone for atrial fibrillation in patients with advanced heart failure. This study assessed the initial rate of success and complications of amiodarone therapy initiated for patients with atrial fibrillation during hospitalization for heart failure. Methods: We reviewed medical records for 37 consecutive patients with left ventricular ejection fractions ≤40% who underwent initiation of amiodarone for atrial fibrillation during hospitalization on a heart failure service. Results: Atrial fibrillation was present in 35 (95%) and atrial flutter in 2 (5%), with mean duration of 30 months. New York Heart Association class was 3.1 (±1.1). Left ventricular ejection fraction was 24% ± 7%. All patients had received oral amiodarone with an initial dose of 1.2 ± 0.2 g/day. Bradyarrhythmia led to discontinuation of digoxin in 12 (32%) patients and to permanent pacemaker placement in 7 (19%) patients. Conversion to sinus rhythm occurred spontaneously in 2 patients and after electrical cardioversion in 26 patients, for an initial success of 76%. After a median follow-up of 9.5 months, 21 of 37 (57%) patients remained in sinus or atrial-paced rhythm. Amiodarone complications occurred after discharge in 5 (14%) patients, 4 with hypothyroidism. Conclusions: Amiodarone with electrical cardioversion has a high initial success rate for treatment of atrial fibrillation in patients with heart failure with advanced systolic dysfunction. The major early side effect was bradyarrhythmia, frequently requiring discontinuation of digoxin or permanent pacemaker placement.

Original languageEnglish (US)
Pages (from-to)638-643
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume19
Issue number7
DOIs
StatePublished - Jul 1 2000

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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