American journal of cardiovascular drugs : drugs, devices, and other interventions
-
Am J Cardiovasc Drugs · Jan 2005
ReviewAntiarrhythmic drugs in patients with implantable cardioverter-defibrillators.
Antiarrhythmic drugs need to be initiated in up to 70% of patients with implantable cardioverter-defibrillators (ICDs) in order to treat atrial tachyarrhythmias, decrease the frequency of defibrillator shocks, and terminate ventricular arrhythmias along with antitachycardia pacing. trial fibrillation (AF) occurs in about 20% of patients with ICDs (the majority with congestive heart failure [CHF]). Antiarrhythmic drugs are initiated for this indication in 2-20% of the ICD population. Data from CHF-STAT (Congestive Heart Failure: Survival Trial of Antiarrhythmic Therapy; amiodarone vs placebo) and DIAMOND-AF (Danish Investigations of Arrhythmia and Mortality ON Dofetilide--rial Fibrillation; dofetilide vs placebo) support the approach that restoration and maintenance of sinus rhythm might be beneficial in CHF, even though no study has specifically addressed the CHF population with ICDs. ⋯ In conclusion, antiarrhythmic drugs are frequently used in ICD patients, the main indications being treatment of atrial tachyarrhythmias and prevention of ICD shocks. Despite potential adverse effects, antiarrhythmics can be administered safely, as long as ICD/drug interactions are appreciated. Controlled studies that will further define the role of concomitant antiarrhythmic drug utilization in patients with ICDs are underway.