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 .
Beneficial effects of low dose amiodarone in patients with congestive cardiac failure: a placebo-controlled trial.
The effects of amiodarone in a low dosage ( 200 mg every 8 h for 2 weeks , then 200 mg/day ) was assessed in a double-blind placebo-controlled trial in 34 patients with a history of severe congestive heart failure but no sustained ventricular arrhythmia .  Left ventricular ejection fraction , treadmill exercise tolerance and 48 h electrocardiographic monitoring were assessed before and repeatedly after beginning amiodarone or placebo therapy over 6 months , and side effects were monitored . In patients receiving amiodarone , the ejection fraction increased significantly from 19 + /- 7 to 29 + /- 15 % at 6 months ( p less than 0.01 from baseline ) , but not significantly in 14 placebo-treated patients ( 18 + /- 5 to 22 + /- 9 % ) . Exercise tolerance increased significantly in amiodarone-treated patients ( median 433 s to 907 s , p less than 0.05 ) , but not significantly in placebo-treated patients ( 757 to 918 s ) . Nonsustained ventricular tachycardia was present in 88 % of amiodarone-treated patients before , but in only 21 % of patients after 6 months of treatment ( p = 0.06 ) ; it was seen in 43 % of placebo-treated patients at baseline and in 50 % after 6 months . Fifty percent of amiodarone-treated patients had side effects ( principally nausea ) and the drug was withdrawn in 28 % of cases ; no life-threatening effects were seen . Low dose amiodarone appears to have a multifaceted potential to produce benefits in arrhythmia control , exercise tolerance and ventricular function in patients with a history of severe congestive heart failure , but better control of side effects ( principally nausea ) appears essential . Effects on mortality could not be determined from this study ; such assessment requires a larger cohort of patients
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 .