Effect of chronic amiodarone therapy on defibrillation energy requirements in humans

Frank Pelosi*, Hakan Oral, Michael H. Kim, Christian Sticherling, Laura Horwood, Bradley P. Knight, Gregory F. Michaud, Fred Morady, S. Adam Strickberger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

Introduction: The effect of oral amiodarone therapy on defibrillation energy requirements in patients with an implantable defibrillator has not been established. Methods and Results: Twenty-one consecutive patients with implantable biphasic waveform defibrillators underwent a step-down determination of the defibrillation energy requirement 211 ± 12 days before and 73 ± 22 days after initiation of amiodarone therapy (mean total dose 26.7 ± 11.1 g). Serum amiodarone and desethylamiodarone concentrations were measured at the time of defibrillation energy requirement determination. The mean defibrillation energy requirement before amiodarone therapy was 9.9 ± 4.6 J. After initiation of amiodarone therapy, the mean defibrillation energy requirement increased to 13.7 ± 5.6 J (P = 0.004). A linear relationship between the amiodarone (P = 0.02, r = 0.6), desethylamiodarone (P = 0.02, r = 0.6), and combined amiodarone-desethylamiodarone concentrations (P = 0.01, r = 0.6) and the defibrillation energy requirement was noted. Stepwise regression analysis demonstrated that the combined amiodarone- desethylamiodarone concentration was the only independent predictor of increase in the defibrillation energy requirement. Conclusion: Chronic oral amiodarone therapy increases the defibrillation energy requirement by approximately 62% in patients with an implantable defibrillator. The combined amiodarone-desethylamiodarone concentration is directly related to the increase in the defibrillation energy requirement.

Original languageEnglish (US)
Pages (from-to)736-740
Number of pages5
JournalJournal of cardiovascular electrophysiology
Volume11
Issue number7
DOIs
StatePublished - 2000

Keywords

  • Defibrillation threshold
  • Implantable defibrillator
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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