Can Amiodarone Prevent Sudden Cardiac Death in Patients with Hemodynamically-Tolerated Sustained Ventricular Tachycardia and Coronary Artery Disease?

One of the most important challenges in today’s practice of cardiology is prevention of sudden cardiac death (SCD) in high risk patients with coronary heart disease (CAD). Hemodynamically-tolerated sustained ventricular tachycardia (HTVT) comprises up to 30% of all cases of monomorphic ventricular tachycardia (MMVT) in patients with CAD. While there is a consensus on treatment of hemodynamically-unstable sustained VT in patients with CAD, some controversies regarding the proper treatment of HTVT exist. We re-examined existing clinical evidence, controversies and current guidelines on the treatment of HTVT in patients with CAD and demonstrated that compared to implantable cardioverter-defibrillators, amiodarone is not an acceptable therapeutic option in patients with ischemic heart disease who suffer from HTVT (Iranian Heart Journal 2006; 7 (1): 47-55).