Efficacy and Safety of Low-Dose Amiodarone Therapy for Tachyarrhythmia in Congenital Heart Disease
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Amiodarone (AMD) is a class III anti-arrhythmic drug that is highly effective for tachyarrhythmia treatment. AMD is widely used in adults with congenital heart disease (CHD); however, higher doses of AMD (> 200 mg/day) can cause various non-cardiac side effects. The purpose of this study was to assess the efficacy, safety, and adverse events of low-dose AMD (≤ 200 mg/day) for tachyarrhythmia in patients with CHD. We retrospectively studied 80 patients with CHD and tachyarrhythmia who received oral low-dose AMD (≤ 200 mg/day) from January 2004 to March 2016. Low-dose AMD therapy was used to treat supraventricular tachycardia (SVT) in 51 patients and ventricular tachycardia (VT) in 29 patients. After a mean follow-up of 2.9 years for SVT and 3.2 years for VT, 36% and 65% of the patients with SVT and VT, respectively, were free from a first tachyarrhythmia recurrence for 3 years. The incidence of AMD-induced side effects was 23%, and all these cases consisted of thyroid dysfunction. Low-dose AMD was effective for the treatment of tachyarrhythmia in patients with CHD and had a relatively low incidence of side effects. These findings suggest that low-dose AMD is useful and effective for decreasing the frequency of tachyarrhythmia in patients with CHD and has a low incidence of side effects.
KeywordsCongenital heart disease Tachyarrhythmia Anti-arrhythmic drug Amiodarone
Compliance with Ethical Standards
Conflict of interest
None of the authors have conflicts of interest to declare.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Von der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Tallenberg JJ, Roos-Hesselink JW (2011) Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 58:2241–2247. https://doi.org/10.1016/j.jacc.2011.08.025 CrossRefPubMedGoogle Scholar
- 4.Engelfriet P, Boersma E, Oechslin E, Tijssen J, Gatzoulis MA, Thilén U, Kaemmerer H, Moons P, Meijboom F, Popelová J, Laforest V, Hirsch R, Daliento L, Thaulow E, Mulder B (2005) The spectrum of adult congenital heart disease in Europe: morbidity and mortality in a 5 years follow-up period: The Euro Heart Survey on adult congenital heart disease. Eur Heart J 26:2325–2333. https://doi.org/10.1093/eurheartj/ehi396 CrossRefPubMedGoogle Scholar
- 17.Takeuchi D, Honda K, Shinohara T, Inai K, Toyohara K, Nakanishi T (2015) Incidence, clinical course, and risk factors of amiodarone-induced thyroid dysfunction in Japanese adults with congenital heart disease. Circ J 79:1828–1834. https://doi.org/10.1253/circj.CJ-15-0042 CrossRefPubMedGoogle Scholar
- 19.Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, Gatzoulis MA, Gohlke-Baerwolf C, Kaemmerer H, Kilner P, Meijboom F, Mulder BJ, Oechslin E, Oliver JM, Serraf A, Szatmari A, Thaulow E, Vouhe PR, Walma E, Task Force on the Management of Grown-up Congenital Heart Disease of the European Society of Cardiology (ESC), Association for European Pediatric Cardiology (AEPC), ESC Committee for Practice Guidelines (CPG) (2010) ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 31:2915–2957. https://doi.org/10.1093/eurheartj/ehq249 CrossRefPubMedGoogle Scholar
- 22.Roy D, Talajic M, Dorian P, Connolly S, Eisenberg MJ, Green M, Kus T, Lambert J, Dubuc M, Gagné P, Nattel S, Thibault B (2000) Amiodarone to prevent recurrence of atrial fibrillation: Canadian trial of atrial fibrillation investigators. N Engl J Med 342:913–920. https://doi.org/10.1056/NEJM200003303421302 CrossRefPubMedGoogle Scholar
- 25.Koyak Z, Kroon B, de Groot JR, Wagenaar LJ, van Dijk AP, Mulder BA, Van Gelder IC, Post MC, Mulder BJ, Bouma BJ (2013) Efficacy of anti-arrhythmic drugs in adults with congenital heart disease and supraventricular tachycardias. Am J Cardiol 112:1461–1467. https://doi.org/10.1016/j.amjcard.2013.07.029 CrossRefPubMedGoogle Scholar
- 27.Domanski MJ, Sakseena S, Epstein AE, Hallstrom AP, Brodsky MA, Kim S, Lancaster S, Schron E (1999) Relative effectiveness of the implantable cardioverter-defibrillator and antiarrhythmic drugs in patients with varying degrees of left ventricular dysfunction who have survived malignant ventricular arrhythmias: AVID Investigators. Antiarrhythmics Versus Implantable Defibrillators. J Am Coll Cardiol 34:1090–1095CrossRefPubMedGoogle Scholar