Sudden cardiac death amiodarone effect

ICDs have been found to be significantly more effective than antiarrhythmic agents such as amiodarone or sotalol for reducing the risk of sudden cardiac death 45,46 therefore, ICDs are preferred therapy.44 However, many patients with ICDs receive concurrent antiarrhythmic drug therapy to reduce the frequency with which patients experience the discomfort of shocks and to prolong battery life of the devices. Combined pharmacotherapy with amiodarone and a 3-blocker is more effective than monotherapy with sotalol or (i-blockers for reduction in the frequency of ICD shocks.47... 

ICD implantation is recommended for prevention of sudden cardiac death in patients with ARVC with documented sustained VT or ventricular fibrillation. Drug therapy with amiodarone or stalol can be effective in selected patients with ARVC. 

Mark, D.B., et al.. Cost-effectiveness of defibrillator therapy or amiodarone in chronic stable heart failure results from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). Circulation, 2006. 114(2) p. 135-42. 

Amrinone [AM ri none] and milrinone [MIL ri none] are phosphodiesterase inhibitors that increase the intracellular concentration of cAMP (Figure 16.11). This results in an increase in intracellular calcium, and therefore cardiac contractility, as discussed above for the P-adrenergic agonists. [Note Recent clinical trials have shown that amiodarone did not reduce the incidence of sudden death or prolong survival in patients with CHF (see p. 172). Milrinone showed increased mortality and no beneficial effects.]... 

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