Electrical Cardioversion and Amiodarone

[domhnalldubh]

Is it common practice for cardioversion patients to be treated with amiodarone both prior to and after being zapped.If so, how much is usually prescribed and for how long. Best wishes to all

[CDreamer]

Yes, short term. I believe the loading dose 200mg for approx 4 weeks prior to cardioversion and up to 3 months following.

Cardioversions are often temporary, sometimes very temporary. Amiodarone gives the best chance of cardioversion working and if successful, lasting. My husband unfortunately didn’t take the Amiodarone in time for his cardioversion so NSR lasted 6 seconds after several zaps. He stayed on Amiodarone however, three months following he converted to NSR. That was in 2018, he still takes a maintenance dose of 100mg/bd which has kept him in NSR.

It is a very toxic drug, has affects but some people seem to tolerate it better than others. Short term use ie: less than 6 months carries less risk of suffering serious affects.

Good luck and why not read the AFA leaflet on Cardioversion and Amiodarone.

api.heartrhythmalliance.org...

api.heartrhythmalliance.org...

Quote:- Studies have shown amiodarone to be one of the most effective antiarrhythmic drugs. It is also safe to use in the elderly and in patients with underlying heart conditions. Amiodarone has many side effects (pulmonary fibrosis, thyroid abnormalities, corneal deposits, abnormal liver function tests, and skin sensitivities) so needs regular monitoring by health care specialists.

[domhnalldubh in reply to CDreamer]

Thanks for your speedy and helpful response. I find it curious that, in the leaflets and other materials I have read ,there is a marked lack of precision about the dosage and the length of treatment. It appears that it all depends on close monitoring and individual tolerance.

[CDreamer in reply to domhnalldubh]

I think you are correct but also different cardiologists/EPs tend to also have different views, usually based on their own patient’s experiences.

I asked a question about 4 years ago on titrating down Amiodarone on behalf of my husband and I had a very interesting reply from a renowned EP who occasionally replies to posts who basically said that at one time he thought that 100mg maintenance dose would not keep AF at bay but tried it having discussed with colleagues who suggested he try it. He changed his mind and recommended that my husband ask his doctor about lowering the dose. Seems to have worked and recent view with GP’s consultant Pharmacist who does ring every six months to go through all the blood tests and asks various questions confirmed that everything is still stable. Amiodarone has a very bad press generally but some, like my husband, tolerate it well.

[Ducky2003]

When I have been off Amiodarone and need a cardioversion, I have been given a loading dose prior. I think it was 3x200mg daily for a week then 2x200g for a week then down to 200mg daily. The maintenance dose for me has been 200mg per day.I have been in it continuously for about 3 years or so, as I would only last a few months in nsr without it.

[domhnalldubh in reply to Ducky2003]

Thanks for your helpful reply

[Ducky2003 in reply to domhnalldubh]

No worries. 😊

[Ppiman]

I have read the same. Amiodarone, despite the negative press from its older usages in high dose and the need for close monitoring, seems to be one of the most effective and safe ways to protect the heart from arrhythmia as it doesn't carry the risk of causing unwanted ventricular arrhythmias.

Steve

[dogsneedwalking]

After unsuccessful Ablation and spending further 10 days in hospital with loading dose of Amiodarone through IV I was on 200mg which was then reduced to 100mg after successful cardioversion 5 months later. However, AFib/Arrhythmias breaking through again and chest pain now accompanying the arrhythmias despite still being on the Amiodarone now for 18months. Awaiting another echocardiogram and referral to 'different' Cardiology Dept for the chest pain. Everyone is different and I hope everyone's experiences helps you in your journey with AFib. Take care.

[pusillanimous]

I wasn't - I was just on an anti coagulant and Biso, and it was done when I had a check up with the Cardio and he found I was in AFib (I'm pretty symptomless) - was admitted and one zap a few hours later when he had finished consulting, and I was waiting for my lift home in no time.

[domhnalldubh in reply to pusillanimous]

Good fortune smiles on the virtuous

[pusillanimous in reply to domhnalldubh]

🤣