Control of tachyarrhythmias associated with Wolff-Parkinson-White syndrome by amiodarone hydrochloride.

Abstract Amiodarone hydrochloride proved to be highly effective in preventing and treating arrhythmias of the Wolff-Parkinson-White (WPW) syndrome in 11 patients with WPW conduction and recurrent tachyarrhythmias. Paroxysmal supraventricular tachycardia (six patients), atrial fibrillation (four patients) and atrial flutter (one patient) were the most significant arrhythmias. In most patients the arrhythmia was seriously disabling because of the extremely rapid ventricular rate, adverse hemodynamic consequences and frequent recurrence and long duration of the episodes. Other known antiarrhythmic agents were ineffective. In all 11 patients amiodarone, in doses of 300 to 600 mg daily, totally, easily and safety controlled the arrhythmias for periods of 2 to 8 months. The drug was fully effective after an average of 7 days of treatment. Tolerance to amiodarone was excellent. The occurrence of corneal microdeposits of the drug was the only Important undesirable effect, but subjective ocular disturbances were not noted. The microdeposits are reversible, and can be avoided by discontinuing the drug for 7 days every 1 to 2 months. Amiodarone apparently causes a significant prolongation of refractoriness in the normal (A-V node and His-Purkinje system) as well as in the anomalous pathway, thus creating favorable conditions for prevention and Interruption of any reentry mechanism requiring participation of both pathways.

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