Combination Drug Therapy Prevents ICD Shocks

Amiodarone plus beta-blocker significantly reduces shocks in patients with implantable cardioverter defibrillators

TUESDAY, Jan. 10 (HealthDay News) -- Amiodarone in combination with a beta-blocker effectively prevents shocks that can occur from an implantable cardioverter defibrillator (ICD), according to a study in the Jan. 11 issue of the Journal of the American Medical Association.

Between 2001 and 2004, Stuart J. Connolly, M.D., of McMaster University in Ontario, Canada, and colleagues studied 412 patients from 39 outpatient ICD clinical centers in Canada, Germany, the United States, England, Sweden and Austria. Patients were randomized to receive one-year treatments of amiodarone plus beta-blocker, sotalol alone, or beta-blocker alone.

The risk of shock in the amiodarone plus beta-blocker group was 73% lower compared to the beta-blocker alone group, and 57% lower compared to the sotalol alone group.

"Should amiodarone or sotalol be administered immediately after ICD implantation or some time before a first shock occurs? By delaying therapy, one reduces the risk of drug-related adverse effects; however, this needs to be balanced against the adverse experience of receiving shock therapy," the authors write. "Therapeutic decisions should be individualized, taking into account possible improvements in quality of life," they conclude.

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