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Abstract

Background: The major concern during amiodarone (AMD) therapy is the adverse effects including pulmonary toxicity. However, low dose AMD may reduce the side effects without loss of anti-arrhythmic efficacy. The aim of this study is to investigate the efficacy and safety of low dose AMD therapy for tachyarrhythmias. Methods and Results: AMD was given in 84 patients (60 males, mean age 66 years) with atrial and/or ventricular tachyarrhythmias and left ventricular dysfunction (mean ejection fraction:0.26±0.12). The major underlying diseases were ischemic heart disease (36) and dilated cardiomyopathy (27). Mean follow-up period was 15±14.1 months. Oral AMD was initially loaded 400 mg daily for 3 days and then maintained between 50 to 200 mg daily. Follow-up examination was performed before and after oral AMD at 1, 3, 6 and every 6 months. Efficacies for arrhythmias were evaluated by symptoms, standard 12-leads ECG, and ambulatory ECG. Mean initial dose was 200±106.8 mg and maintenance dose was 100±62.6 mg daily. During follow-up period, targeted tachyarrhythmias were successfully suppressed in 66 (78.6%) of 84 patients. Adverse effects were observed in 16 patients (19.0%); thyroid dysfunction (11.9%), liver dysfunction (2.4%), pulmonary toxicity, finger tremor, hypogeusia and sinus bradycardia, respectively (1.2%). Pulmonary toxicity was not lethal and no progression was observed with reducing use of AMD. Conclusion: Low dose AMD therapy was effective for suppression of tachyarrhythmias with impaired cardiac function and safely administered with few serious complications.

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