Abstract 16548: Low-dose Amiodarone for Control of Atrial Fibrillation (AF) Remains Effective in Patients With Ejection Fraction Less Than 50%

Abstract

Introduction: Our previous work has shown low-dose Amiodarone (often less than 600 mg per week) is effective for control of AF in a forced down-titration schema. Many studies have shown restoration of sinus rhythm in patients with CHF shows promise for reduced mortality and morbidity. This analysis compares results of this protocol in patients with ejection fraction above and below 50%. Methods: Consecutive patients with atrial fibrillation deemed suitable for Amiodarone therapy were prospectively followed with a forced down-titration protocol. Controlled atrial fibrillation was defined as an AF burden of less than 1% on device diagnostics (30% of patients) or no symptoms and sinus rhythm on clinical visit EKGs. Demographic and clinical data were analyzed for patients with ejection fraction above and below 50%. Results: Patients with EF less than 50% had greater success (35/38) or 92% than patients with ejection fraction greater than 50% (39/51) or 76%. However, patients with ejection fraction under 50% required larger doses. See graph for detailed doses. Overall success was good in both groups with no sustained side effects. Conclusions: Amiodarone in low doses is effective in control of atrial fibrillation in patients across the spectrum of ejection fractions. Lower ejection fractions may require a somewhat higher dose (less than 1000 mg per week) but at a higher success rate.Larger studies could potentially show the impact of this protocol on mortality.