Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .
Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality.
BACKGROUND We sought to assess the association of amiodarone use with mortality during consecutive periods in patients with post-acute myocardial infa rct ion with left ventricular systolic dysfunction and /or HF treated with a contemporary medical regimen . METHODS This study used data from VALIANT , a r and omized comparison of valsartan , captopril  , or both in patients with acute myocardial infa rct ion with HF and /or left ventricular systolic dysfunction . We compared baseline characteristics of 825 patients treated with amiodarone at r and omization with 13,875 patients not treated with amiodarone .  Using Cox models , we examined the association of amiodarone use with subsequent mortality during consecutive periods after r and omization ( days 1 - 16 , 17 - 45 , 46 - 198 , and 199 - 1096 ) . RESULTS Patients treated with amiodarone were older , had higher Killip class , and were more likely to have a history of diabetes mellitus and hypertension . Adjusting for baseline predictors of mortality , we found that amiodarone use was associated with a significant increase in mortality during 3 of the 4 periods : hazard ratio 1.5 , 95 % CI ( 1.1 - 2.0 ) , P = .02 , for days 1 to 16 ; 2.1 ( 1.5 - 2.9 ) , P < .001 , for days 17 to 45 ; 1.1 ( 0.83 - 1.46 ) , P = .51 , for days 46 to 198 ; and 1.4 ( 1.2 - 1.6 ) , P < .001 , for days 199 to 1096 . CONCLUSION In this study , amiodarone use was associated with excess early and late all-cause and cardiovascular mortality . These observational findings are in contrast to earlier r and omized trials of amiodarone and need to be vali date d prospect ively
Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .