IMR Press / RCM / Volume 22 / Issue 4 / DOI: 10.31083/j.rcm2204143
Open Access Review
Amiodarone in ventricular arrhythmias: still a valuable resource?
Show Less
1 Vita-Salute University, 20132 Milan, Italy
2 Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele University Hospital, 20132 Milan, Italy
3 Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele University Hospital, 20132 Milan, Italy
4 Cardiac Intensive Care Unit, IRCCS San Raffaele University Hospital, 20132 Milan, Italy
5 Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy
6 Anesthesia Intensive Care, IRCCS San Raffaele University Hospital, 20132 Milan, Italy
7 Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
*Correspondence: d'angelo.giuseppe@hsr.it (Giuseppe D’Angelo)
These authors contributed equally.
Academic Editor: Grigorios Korosoglou
Rev. Cardiovasc. Med. 2021, 22(4), 1383–1392; https://doi.org/10.31083/j.rcm2204143
Submitted: 14 August 2021 | Revised: 1 November 2021 | Accepted: 2 November 2021 | Published: 22 December 2021
(This article belongs to the Special Issue State-of-the-Art Cardiovascular Medicine in Europe 2022)
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Ventricular arrhythmias still represent an important cause of morbidity and mortality, especially in patients with heart failure and reduced left ventricular ejection fraction. Amiodarone is a Class III Vaughan-Williams anti-arrhythmic drug widely used in ventricular arrhythmias for its efficacy and low pro-arrhythmogenic effect. On the other hand, a significant limitation in its use is represented by toxicity. In this review, the pharmacology of the drug is discussed to provide the mechanistic basis for its clinical use. Moreover, all the latest evidence on its role in different clinical settings is provided, including the prevention of sudden cardiac death, implanted cardioverter defibrillators, ischemic and non-ischemic cardiomyopathies. A special focus is placed on everyday clinical practice learning points, such as dosage, indications, and contraindications from the latest guidelines.

Keywords
Amiodarone
Heart failure
Ventricular tachycardia
Catheter ablation
Pharmacology
Figures
Fig. 1.
Share
Back to top