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Intravenous amiodarone bolus immediately controls heart rate in patients with atrial fibrillation accompanied by severe congestive heart failure
  1. ROBERT HOFMANN,
  2. GOTTFRIED WIMMER,
  3. FRANZ LEISCH
  1. General Hospital Linz
  2. Cardiovascular Division
  3. Krankenhausstrasse 9
  4. A-4020 Linz, Austria
  5. robert.hofmann@akh.linz.at

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Atrial fibrillation with a rapid ventricular rate often adds to the impaired haemodynamic status of patients with depressed left ventricular function.1 Intravenous amiodarone has been shown to be effective in slowing the heart rate during atrial fibrillation.2 For continuous infusion of the drug a central venous access is recommended.3 We tested the hypothesis that amiodarone, given as a single bolus through a peripheral vein access, is effective and does not cause phlebitis.

Forty patients with documented heart disease and atrial fibrillation (ventricular heart rate ⩾ 135 beat/min) were included in the study. Mean (SD) age of the patients was 72 (12) years, 22 were men, and the mean ejection fraction was 38 (12)%. Cardiogenic shock was present in eight patients, 12 had pulmonary oedema, and 20 had exacerbated congestive heart failure. Mean systolic blood pressure was 111 (28) mm Hg. The onset of the tachyarrhythmia could be documented in 18 patients within 24 hours (15 (13) hours) before amiodarone treatment; in the remaining 22 patients the duration was unknown. Depending on clinical presentation and duration of the arrhythmia, patients were pretreated with digoxin, verapamil, or β blockers. All …

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