Effects of amiodarone: A Synthesis of Findings from 11 Studies

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Original Abstract of the Article

Major Research Findings

Amiodarone is an effective antiarrhythmic medication, but it can cause a range of side effects, including eye problems, as shown in 10 . It primarily works by altering the electrical activity of the heart, specifically prolonging the action potential and repolarization time, which increases the refractory period and reduces membrane excitability. 4 provides a detailed explanation of this mechanism. While effective for treating ventricular tachycardia and fibrillation, 5 explores a short-acting derivative, E 047/1, offering a more manageable approach for patients experiencing these issues after cardiac surgery. Further, 3 highlights amiodarone's potential to reduce mortality by approximately 20-25% in patients with chronic heart failure, but also notes a substantial increase in side effects (120-124%). Studies like 11 have shown that amiodarone, along with lidocaine, can lead to a higher rate of hospital admission following cardiac arrest. Furthermore, 8 and 6 delve into the treatment of atrial fibrillation using amiodarone, comparing its effects to sotalol and diltiazem, respectively. 1 examines the relationship between amiodarone's concentration in various bodily compartments (plasma, red blood cells, myocardium) and its hemodynamic effects in surgical patients. Finally, 7 investigates the dynamic relationship between QT and RR intervals as a potential predictor of amiodarone's effectiveness, while 9 introduces dronedarone, a newer antiarrhythmic drug developed to reduce the adverse effects associated with amiodarone.

Benefits and Risks

Benefit Summary

Amiodarone proves beneficial in treating various cardiac arrhythmias, particularly ventricular tachycardia and fibrillation. 4 suggests a potential increase in survival rates after cardiac arrest when using amiodarone. 3 further highlights its ability to lower mortality in patients with chronic heart failure. 5 emphasizes its effectiveness in managing post-cardiac surgery ventricular tachycardia.

Risk Summary

Amiodarone carries a notable risk of side effects, particularly eye-related complications and systemic issues. 10 provides a comprehensive overview of these potential adverse effects. 3 emphasizes the higher risk of side effects associated with amiodarone use.

Comparison Between Studies

Commonalities

Many studies explore amiodarone's effectiveness in treating cardiac arrhythmias and its associated side effects. 4 and 5 demonstrate its effectiveness in treating ventricular arrhythmias, while 3 highlights both its benefits and risks in treating chronic heart failure.

Differences

Studies differ in their focus and methodologies, ranging from clinical trials to systematic reviews and meta-analyses. Some, such as 5 , explore specific formulations, like the short-acting derivative E 047/1. Others, like 8 and 6 , conduct direct comparisons with alternative medications.

Consistency and Contradictions

Amiodarone's effectiveness in treating cardiac arrhythmias is consistent across various studies, but the risk of side effects remains a concern. Some studies, like 11 , highlight its potential to increase hospital admission rates, while others, like 3 demonstrate its ability to improve survival rates. This variability necessitates further investigation to clarify the nuanced effects of amiodarone.

Practical Applications and Considerations

While amiodarone is a valuable tool for managing cardiac arrhythmias, it's crucial to be aware of its potential side effects. If considering amiodarone, consult with a physician to understand the risks and benefits, ensuring the treatment aligns with your individual needs.

Limitations of Current Research

Existing research often lacks comprehensive information regarding the long-term effects and detailed nature of amiodarone's side effects. Additionally, many studies focus on specific patient groups, making it unclear whether the findings can be extrapolated to broader populations.

Future Research Directions

Further research is essential to gain a more thorough understanding of amiodarone's long-term effects, its optimal use in various patient populations, and detailed insights into its side effects. Direct comparisons with other antiarrhythmic medications are also crucial to establish clear treatment guidelines.

Conclusion

Amiodarone remains a valuable antiarrhythmic medication but comes with a risk of side effects. When considering this treatment, open communication with your physician is vital to weigh the potential benefits against the risks, ensuring you make an informed decision regarding your health.

Literature analysis of 11 papers
Positive Content
8
Neutral Content
0
Negative Content
3
Article Type
8
3
2
1
11
1.

Amiodarone and N-desethylamiodarone concentrations in plasma, red blood cells, and myocardium after a single oral dose: relation to hemodynamic effects in surgical patients.

Author: EscoubetB, JaillonP, BergerY, ComminP, MenaschéP, PiwnicaA, EchterE

Impaired hemodynamics

Oral amiodarone, an antiarrhythmic drug, was found to impair hemodynamics in surgical patients. The drug decreased cardiac index and heart rate, and increased capillary wedge pressure. Measuring amiodarone plasma concentration was the easiest method for monitoring the drug, but further investigation is needed to determine the clinical utility of drug monitoring during chronic administration.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

[Intravenous administration of lidocaine and amiodarone in patients with acute myocardial infarction].

Author: CapucciA, MelandriG, MantovaniB, MarestaA, MagnaniB

Reduced ventricular arrhythmias
Blood pressure decrease
QTc prolongation
Ventricular fibrillation

Amiodarone was as effective as lidocaine in treating life-threatening ventricular arrhythmias in patients with acute myocardial infarction. Amiodarone prolonged the QTc interval and slightly decreased systolic blood pressure.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Italian

3.

Overview and meta-analysis of randomised trials of amiodarone in chronic heart failure.

Author: PiepoliM, VillaniG Q, PonikowskiP, WrightA, FlatherM D, CoatsA J

Reduction in deaths
Increased side effects

This article reviews the use of amiodarone in patients with heart failure. While meta-analysis suggests a significant reduction in deaths, it also highlights a significant increase in side effects associated with amiodarone use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

4.

Intravenous amiodarone for ventricular arrhythmias: overview and clinical use.

Author: GonzalezE R, KannewurfB S, OrnatoJ P

Arrhythmia Treatment
Cardiac Arrest Survival

Intravenous amiodarone is an effective anti-arrhythmic agent for the acute treatment of life-threatening ventricular arrhythmias, such as ventricular tachycardia and fibrillation. The drug's efficacy has been demonstrated in clinical trials, including the ARREST trial which showed improved survival in amiodarone-treated patients following cardiac arrest.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

First clinical experience with the rapid-, short-acting amiodarone derivative E 047/1 after cardiac surgery.

Author: GombotzH, VicenziM, MahlaE, RehakP, MetzlerH

Easier to titrate
Effective against dysrhythmias
Many undesired side-effects
Poor pharmacodynamic properties

E 047/1, a derivative of amiodarone, is effective for treating cardiac dysrhythmias.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Effects of amiodarone and diltiazem on persistent atrial fibrillation conversion and recurrence rates: a randomized controlled study.

Author: ManiosEmmanuel G, MavrakisHercules E, KanoupakisEmmanuel M, KallergisEleftherios M, DermitzakiDespina N, KambourakiDespina C, VardasPanos E

Increased conversion rate
Preserved sinus rhythm
Prolonged sinus rhythm

Oral amiodarone increases conversion rates, prolongs fibrillatory cycle length and atrial effective refractory period, and preserves sinus rhythm after cardioversion in persistent AF patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Individual patterns of dynamic QT/RR relationship in survivors of acute myocardial infarction and their relationship to antiarrhythmic efficacy of amiodarone.

Author: SmetanaPeter, PueyoEsther, HnatkovaKaterina, BatchvarovVelislav, LagunaPablo, MalikMarek

Effective antiarrhythmic drug
Serious side effects

Amiodarone, an antiarrhythmic drug, is effective in treating heart rhythm problems, but it has serious side effects. This study investigated whether certain markers could be used to predict which patients would not benefit from amiodarone treatment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

[Effects of amiodarone versus sotalol in treatment of atrial fibrillation: a random controlled clinical study].

Author: NiuFan, HuangCong-xin, JiangHong, YangBo, GuoWen-ling, ChenYun-xia, JinChun-rong, LiuZhuo-min

Atrial fibrillation conversion
Sinus rhythm maintenance
Bradycardia

Amiodarone is more effective than sotalol in converting atrial fibrillation to sinus rhythm and maintaining sinus rhythm. The adverse reaction of amiodarone on the heart is less severe than that of sotalol.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Chinese

9.

Dronedarone for maintenance of sinus rhythm in atrial fibrillation or flutter.

Author: SinghBramah N, ConnollyStuart J, CrijnsHarry J G M, RoyDenis, KoweyPeter R, CapucciAlessandro, RadzikDavid, AliotEtienne M, HohnloserStefan H,

Reduced ventricular rate
Sinus rhythm maintenance
Pulmonary toxic effects
Thyroid and liver dysfunction

Dronedarone was significantly more effective than placebo in maintaining sinus rhythm and reducing ventricular rate during recurrence of arrhythmia. There was no evidence that dronedarone increased the risk of pulmonary toxicity, thyroid dysfunction, or liver dysfunction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Ocular Adverse Effects of Amiodarone: A Systematic Review of Case Reports.

Author: AlshehriMona, JouryAbdulaziz

amiodarone
ocular adverse effects

Cornea verticillata/vortex keratopathy was the most common ocular adverse effect of amiodarone, an antiarrhythmic medication, in 25 case reports. Early recognition of amiodarone-induced ocular adverse effects is crucial to prevent worsening keratopathy or other adverse effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Amiodarone and/or lidocaine for cardiac arrest: A Bayesian network meta-analysis.

Author: ZhaoHongli, FanKai, FengGuilong

Increased hospital admission

This meta-analysis assessed the efficacy of amiodarone and/or lidocaine during cardiac arrest. While studies haven't shown improved long-term survival with antiarrhythmic drugs, some suggest higher hospitalization rates with amiodarone or lidocaine compared to placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

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