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Atrial fibrillation is associated with considerable morbidity and mortality and is increasing in prevalence. A safe, effective treatment for AF is the Holy Grail of modern cardiac electrophysiology research. At present, amiodarone is the most effective pharmacologic agent for treating AF, but its use is constrained by concerns about serious noncardiac adverse effects. A new study from a Dutch consortium explores whether minimizing the daily and cumulative doses of amiodarone might reduce its toxicity.
A total of 209 patients with AF received a 4-week loading dose (600 mg/day) of amiodarone, underwent electrical cardioversion if necessary to establish sinus rhythm, and then were randomized to receive continuous amiodarone (200 mg/day) or epis…