Intravenous amiodarone in the treatment of refractory arrhythmias

Oral amiodarone's slow absorption handicaps rapid treatment of life-threatening arrhythmias. We used iv amiodarone to treat ten patients with hemodynamically significant atrial arrhythmias and life-threatening ventricular arrhythmias refractory to all conventional medical treatment. Arrhythmias were controlled in nine patients, five of whom became long-term survivors on oral amiodarone. Two patients died of cardiovascular collapse within 24 h of initiation of iv amiodarone. One other patient died postoperatively of cardiovascular collapse while on oral amiodarone, 2 wk after iv amiodarone. Another patient died of an unrelated cause 13 months after initiation of amiodarone. These results suggest that iv amiodarone is effective in controlling refractory atrial and ventricular arrhythmias and may shorten the latency period.