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Since its U.S. debut in 1986, amiodarone has gained acceptance as a valuable antiarrhythmic for ventricular arrhythmias, but until recently only the oral preparation was available. In nonrandomized studies of IV amiodarone in patients with ventricular tachycardia or fibrillation (VT/VF) efficacy rates of 50% to 75% have been reported. This multicenter study compared the safety and efficacy of IV amiodarone versus bretylium, the only class 3 antiarrhythmic agent currently approved in the United States for treatment of sustained VT/VF.
Subjects were 302 patients with refractory, hemodynamically unstable VT/VF. More than 75% were male and had a previous MI; all were refractory to or intolerant of lidocaine and procainamide. Patients were random…