Which medications in the drug class Antidysrhythmics, III are used in the treatment of Cardiac Amyloidosis?

Updated: Mar 25, 2020
  • Author: Gyanendra K Sharma, MD, FACC, FASE; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Antidysrhythmics, III

Antiarrhythmics are useful in patients with supraventricular and nonsustained ventricular tachycardias. Not all antiarrhythmics are considered safe in patients with structural heart disease.

Amiodarone (Cordarone)

Amiodarone may inhibit atrioventricular conduction and sinus node function. It prolongs the action potential and refractory period in myocardium and inhibits adrenergic stimulation. Amiodarone may improve mortality rates in patients with cardiomyopathy.

It is better tolerated and should be used in patients with atrial fibrillation. Amiodarone can be used intravenously (150 mg IV bolus; then 1 mg/minute for 6 hrs followed by 0.5 mg/minute for 18 hrs or by mouth 400 mg 3 times daily for 7 days followed by 400 mg twice daily for 1 week as a loading dose. The usual maintenance dose is 200-400 mg daily. The patients should be closely followed for amiodarone toxicity, including QT prolongation, hepatic, and thyroid function abnormalities. Dose of warfarin should be reduced, and digoxin should not be administered concurrently with amiodarone in patients with amyloidosis.


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