FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Volume 333:77-82 July 13, 1995 Number 2 Next

Abstract PDF Letters Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Asymptomatic ventricular arrhythmias in patients with congestive heart failure are associated with increased rates of overall mortality and sudden death. Amiodarone is now used widely to prevent ventricular tachycardia and fibrillation. We conducted a trial to determine whether amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.

Methods We used a double-blind, placebo-controlled protocol in which 674 patients with symptoms of congestive heart failure, cardiac enlargement, 10 or more premature ventricular contractions per hour, and a left ventricular ejection fraction of 40 percent or less were randomly assigned to receive amiodarone (336 patients) or placebo (338 patients). The primary end point was overall mortality, and the median follow-up was 45 months (range, 0 to 54).

Results There was no significant difference in overall mortality between the two treatment groups (P = 0.6). The two-year actuarial survival rate was 69.4 percent (95 percent confidence interval, 64.2 to 74.6) for the patients in the amiodarone group and 70.8 percent (95 percent confidence interval, 65.7 to 75.9) for those in the placebo group. At two years, the rate of sudden death was 15 percent in the amiodarone group and 19 percent in the placebo group (P = 0.43). There was a trend toward a reduction in overall mortality among the patients with nonischemic cardiomyopathy who received amiodarone (P = 0.07). Amiodarone was significantly more effective in suppressing ventricular arrhythmias and increased the left ventricular ejection fraction by 42 percent at two years.

Conclusions Although amiodarone was effective in suppressing ventricular arrhythmias and improving ventricular function, it did not reduce the incidence of sudden death or prolong survival among patients with heart failure, except for a trend toward reduced mortality among those with nonischemic cardiomyopathy.

Patients with congestive heart failure and ventricular arrhythmias are at particularly high risk for fatal cardiovascular events.^6,7,8,9 Among patients with frequent and complex ventricular arrhythmias on Holter monitoring, the annual mortality rate is about 15 percent, and half the deaths are sudden, presumably caused by cardiac arrhythmias.^6,7,8,9 Attempts have been made to suppress ventricular arrhythmias with antiarrhythmic agents, in the expectation of prolonging survival.^10,11,12 The Cardiac Arrhythmia Suppression Trials showed that the suppression of arrhythmias with encainide or flecainide increased mortality among patients with myocardial infarction.^13,14

The results of several small studies suggest that amiodarone may be beneficial in the treatment of patients with recent infarction.^15,16 Amiodarone is a powerful antiarrhythmic agent that markedly suppresses complex premature ventricular contractions and unsustained ventricular tachycardia, with little depressant effect on hemodynamic function.¹⁷ The drug does not have important proarrhythmic effects.^18,19 We therefore tested the hypothesis that amiodarone can prolong survival among patients with heart failure and asymptomatic but frequent and complex ventricular arrhythmias.

Methods

The design of the trial has been described elsewhere.¹⁹ Patients were screened at 24 centers, listed in the Appendix. The protocol was approved by an institutional review board at each center, and all patients gave informed consent. The conduct of the study was monitored by an external data and safety monitoring board and by the Human Rights Committee of the Hines Veterans Affairs Cooperative Studies Program Coordinating Center.

Patients with a documented history of congestive heart failure, whether ischemic or nonischemic in origin, and at least 10 ventricular premature beats per hour, unaccompanied by symptoms, were eligible for the study. All patients had shortness of breath on exertion or paroxysmal nocturnal dyspnea, an echocardiogram showing a left ventricular internal diameter of at least 55 mm or a cardiothoracic ratio higher than 0.50, and a left ventricular ejection fraction of 40 percent or less. All patients received vasodilator therapy. Digoxin and diuretics were administered as deemed appropriate by the treating physicians.

Women of childbearing age were excluded from the study. Other criteria for exclusion were myocardial infarction within the three months before enrollment, symptomatic ventricular arrhythmia, a history of aborted sudden cardiac arrest or sustained ventricular tachycardia, uncontrolled thyroid disease, the need for antiarrhythmic therapy, electrocardiographic changes in the QRS interval (greater/equal 180 msec) or QTc interval (greater/equal 500 msec), a serious disease other than heart disease that was likely to be fatal within three years, and symptomatic hypotension or systolic blood pressure under 90 mm Hg.

Before randomization, the patients were stratified according to the cause of their heart disease (ischemic or nonischemic), the ejection fraction (<30 percent or 30 to 40 percent), and the participating hospital at which the patient was receiving care. Ischemic heart disease was documented on the basis of coronary angiographic studies, electrocardiographic changes indicative of myocardial infarction, and chest pain typical of angina with concomitant electrocardiographic changes or reversible defects on radioisotope perfusion scans. Each patient was randomly assigned to receive amiodarone (800 mg once a day for 14 days, then 400 mg once a day for 50 weeks, and then 300 mg once a day until the end of the study) or placebo throughout the trial. Clinic visits were made after 2 weeks and then monthly until the end of the study (maximal follow-up, 4.5 years). At each visit, a complete history was taken and a physical examination performed, with documentation of side effects and use of concomitant drugs.

A 24-hour continuous electrocardiogram was obtained at base line; at 2 weeks; at months 1, 3, 6, 9, and 12; and then every 6 months. Chest films (with the cardiothoracic ratio calculated), blood gas values, and pulmonary-function values were determined annually. The left ventricular ejection fraction was determined by radionuclide ventriculography at base line and at months 6, 12, and 24. Echocardiograms were obtained at base line and at months 12 and 24. Deaths and aborted cardiac arrests were reviewed in a blinded manner by a committee and classified as sudden or nonsudden deaths from cardiac causes or deaths from other causes. In patients with sustained ventricular tachycardia (greater/equal 30 seconds), symptomatic unsustained ventricular tachycardia, or intolerable side effects, the study drug was withdrawn, but the patients were followed and included in the statistical analyses.

Patients were recruited for the study over a period of 3.5 years, and all patients were followed for 1 additional year after the enrollment period. Compliance was ensured by means of frequent clinic visits, telephone calls, and pill counts.

The study end points were overall mortality and sudden death from cardiac causes. Other factors examined included the effects of amiodarone on the left ventricular ejection fraction and on the suppression of ventricular arrhythmias.

Statistical Analysis

All patients were followed until the completion of the study and were included in the statistical analysis according to the intention-to-treat principle. Continuous and categorical data were compared at base line by the t-test and chi-square test, respectively. Differences in survival were analyzed with the Kaplan-Meier method. Data on surviving patients were censored at the date of the last follow-up visit. For the analysis of sudden deaths, data on deaths from other causes were censored on the date of the death. A two-sided alpha level less than or equal to 0.05 was considered to indicate statistical significance.

Results

Characteristics of the Patients

During the 3.5-year period of enrollment, 1303 patients were screened, and 674 (52 percent) were randomly assigned to one of two treatment groups. A total of 336 patients were assigned to the amiodarone group, and 338 to the placebo group. The base-line characteristics of the randomized patients are shown in Table 1. The mean age of the entire group was 66 years. The median period of follow-up was 45 months (range, 0 to 54).

View this table: [in this window] [in a new window]   Table 1. Base-Line Characteristics of 674 Patients with Congestive Heart Failure Who Were Randomly Assigned to Receive Amiodarone or Placebo.

 
Overall Mortality and Sudden Death

Amiodarone had no significant effect on survival. There were 274 deaths during the study: 131 (39 percent) in the amiodarone group and 143 (42 percent) in the placebo group. The overall actuarial survival at two years was 69.4 percent (95 percent confidence interval, 64.2 to 74.6 percent) in the amiodarone group and 70.8 percent (95 percent confidence interval, 65.7 to 75.9 percent) in the placebo group (P = 0.6) (Figure 1).

View larger version (5K): [in this window] [in a new window]   Figure 1. Kaplan-Meier Estimates of Overall Mortality and Sudden Death from Cardiac Causes. Amiodarone had no significant effect, as compared with placebo, on either overall mortality or the incidence of sudden death. The numbers below the figures are the numbers of patients at risk.

 
Sixty-four of the deaths in the amiodarone group (49 percent) and 75 of those in the placebo group (52 percent) were classified as sudden. The death was ascribed to pump failure in 34 patients in the amiodarone group (26 percent) and in 40 patients in the placebo group (28 percent); 22 patients in the amiodarone group (17 percent) and 23 in the placebo group (16 percent) died from noncardiac causes. The cause of death could not be ascertained in 11 patients in the amiodarone group and in 5 in the placebo group. As compared with placebo, amiodarone had no significant effect on sudden death; at two years, the rate of sudden death was 15 percent in the amiodarone group and 19 percent in the placebo group (P = 0.43) (Figure 1).

Influence of Cause of Heart Failure on Outcome

Coronary artery disease was diagnosed in 242 of the patients assigned to amiodarone (72 percent) and in 239 of those assigned to placebo (71 percent). Survival curves, according to the cause of heart disease, are shown in Figure 2. As compared with placebo, amiodarone had no significant effect on overall mortality among patients with ischemic heart disease (Figure 2), but there was a trend in favor of amiodarone over placebo among those with nonischemic heart disease (P = 0.07) (Figure 2).

View larger version (6K): [in this window] [in a new window]   Figure 2. Kaplan-Meier Estimates of Overall Mortality, According to the Presence or Absence of Ischemic Cardiomyopathy. Among the patients with ischemic cardiomyopathy, amiodarone had no significant effect on mortality, as compared with placebo; among those with heart failure of nonischemic origin, there was a trend toward a reduction in overall mortality induced by amiodarone. The numbers below the figures are the numbers of patients at risk.

 
Suppression of Ventricular Arrhythmias

At base line the mean (±SD) heart rate was similar in the two treatment groups (Table 1). After two weeks of treatment, the heart rate was significantly lower in the group assigned to amiodarone (70 ±12 beats per minute, as compared with 79 ±13 in the placebo group; P<0.001). This difference persisted throughout the study.

At randomization, the mean frequency of premature ventricular contractions in the amiodarone group was 254 ±370 per hour, with 77 percent of the patients having one or more episodes of ventricular tachycardia. In the placebo group, the mean frequency of premature ventricular contractions was 279 ±387 per hour, with 85 percent of the patients having episodes of ventricular tachycardia. Two weeks after randomization, the average frequency of premature ventricular contractions was 266 ±412 per hour in the placebo group, and it did not change significantly thereafter. In contrast, in the amiodarone group, the frequency of premature ventricular contractions fell to 66 ±156 per hour (P<0.001) at two weeks and to 44 ±145 per hour (P<0.001) at three months. In the placebo group, 76 percent of the patients continued to have episodes of ventricular tachycardia two weeks after randomization. In the amiodarone group, only 33 percent of the patients had episodes of ventricular tachycardia at two weeks, as compared with 77 percent at base line (P<0.001), and the frequency of episodes of ventricular tachycardia remained lower in that group than in the placebo group throughout the study. Symptomatic ventricular tachycardia developed in 18 patients in the amiodarone group and in 20 in the placebo group (P not significant).

Survival did not differ significantly between the 159 patients in whom ventricular arrhythmias (premature ventricular contractions) were suppressed by 80 percent or more after two weeks of amiodarone therapy and the 71 patients in whom such suppression was not achieved (P = 0.93) (Figure 3). Similarly, with respect to mortality, there was no significant difference between the group of 111 patients in whom episodes of ventricular tachycardia were eliminated by amiodarone at two weeks and the group of 65 patients in whom such episodes continued to occur (P = 0.36). Moreover, in the subgroup of patients with ventricular tachycardia at base line, amiodarone, as compared with placebo, had no effect on mortality.

View larger version (3K): [in this window] [in a new window]   Figure 3. Kaplan-Meier Estimates of Overall Mortality, According to the Effect of Amiodarone on Premature Ventricular Contractions. The comparison is between the patients in whom premature ventricular contractions were suppressed by 80 percent or more and the patients in whom this level of suppression was not achieved. For the purpose of the analysis, runs of ventricular tachycardia are included. There was no significant difference between the group with suppressed contractions and the group with unsuppressed contractions. A similar analysis revealed no significant difference in overall mortality between the group in which runs of ventricular tachycardia were present after two weeks of therapy and the group in which such runs were absent. The numbers below the figure are the numbers of patients at risk.

 
Effect of Amiodarone on Left Ventricular Ejection Fraction

At randomization, the mean ejection fraction was 24.9 ±8.3 percent in the amiodarone group and 25.7 ±8.2 percent in the placebo group. The patients in the amiodarone group had a significant improvement in the ejection fraction at six months (33.7 ±11.0 percent, as compared with 29.2 ±10.7 in the placebo group; P<0.001). At 12 and 24 months, the mean ejection fractions in the amiodarone group were 33.4 ±11.9 and 35.4 ±11.5 percent, respectively. These values were significantly higher than those in the placebo group (29.7 ±11.0 and 29.8 ±12.2 at 12 and 24 months, respectively; P<0.001).

The overall mortality did not differ significantly between the two treatment groups according to the level of the left ventricular ejection fraction (<30 percent or 30 to 40 percent). In both treatment groups, however, patients with a left ventricular ejection fraction under 30 percent had lower survival rates than those with a left ventricular ejection fraction of 30 to 40 percent (P<0.001).

Side Effects

The frequency of adverse effects during the study is shown in Table 2. Abnormalities in thyroid function were observed in four patients in the amiodarone group (1.2 percent) and in two patients in the placebo group (0.6 percent). Elevated hepatic-enzyme levels (at least twice the normal values) were seen in four patients in the amiodarone group (1.2 percent) and in two in the placebo group (0.6 percent). Severe pulmonary fibrosis occurred in four patients in the amiodarone group (1.2 percent) and in three patients in the placebo group (0.9 percent). There were no episodes of torsade de pointes in either group.

View this table: [in this window] [in a new window]   Table 2. Severe Adverse Reactions.

 
The study medication was discontinued in 90 patients in the amiodarone group (27 percent) and in 78 patients in the placebo group (23 percent) because of intolerable side effects, as defined by the protocol or as decided by the physician or the patient; the difference between the two groups was not statistically significant (P = 0.1). An additional 46 patients in the amiodarone group and 32 in the placebo group withdrew from the study or were lost to follow-up.

Discussion

Our study shows that amiodarone, as compared with placebo, had no effect on overall mortality or sudden death, despite significant suppression of ventricular arrhythmias and a significant increase in the left ventricular ejection fraction. However, we observed a trend toward a lower mortality rate among patients with nonischemic cardiomyopathy who received amiodarone. There was no relation between the degree of impairment in the left ventricular ejection fraction (<30 percent or 30 to 40 percent) at base line and the effect of amiodarone on overall mortality.

Amiodarone is known to be effective in controlling life-threatening arrhythmias.^20,21,22 There is also evidence that the drug may be effective in reducing cardiac-related and overall mortality in survivors of myocardial infarction.^15,16 Our findings in patients with heart failure were therefore unexpected. In previous, smaller studies, the results have been variable. For example, in retrospective studies, Cleland et al.¹² and Chatterjee¹⁰ reported improved survival in patients with heart failure treated with amiodarone, whereas a small, prospective, randomized trial reported by Nicklas et al.²³ found no benefit. A recent study²⁴ from Argentina (Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina, or GESICA) reported a 28 percent reduction in overall mortality in the amiodarone group as compared with a control group (P = 0.024). The rates of sudden death and death due to progressive heart failure were reduced by 27 and 23 percent, respectively (P = 0.16). The fact that the GESICA trial was not blind probably does not explain the discrepancy between these results and ours. The most striking difference between the two studies is that the proportion of patients with coronary artery disease in the GESICA trial was smaller (39 percent) than in our study (70 percent). This difference is important, since in our study there was a trend toward a reduction in mortality among the patients with nonischemic cardiomyopathy (P = 0.07).

In our study, amiodarone increased the left ventricular ejection fraction by 42 percent at two years, confirming the results of previous studies.¹⁷ These data are consistent with the observation that amiodarone may improve the capacity for exercise in patients with heart failure.²⁵ The observed improvement in systolic function may be related to the drug's property of lengthening the period of repolarization.²⁶ Increases in left ventricular ejection fraction induced by cardioactive drugs are often not positively correlated with a reduction in mortality.^27,28 Indeed, certain inotropic agents, such as beta-agonists and phosphodiesterase inhibitors, may even decrease survival,²⁷ although they increase ventricular function. In the second Vasodilator-Heart Failure Trial, a combination of hydralazine and isosorbide dinitrate resulted in a significantly greater improvement in the left ventricular ejection fraction but a higher mortality rate than treatment with enalapril.⁵ Thus, there appears to be no systematic relation between changes in the left ventricular ejection fraction induced by amiodarone or other cardioactive drugs and their effect on survival.

Our data on amiodarone indicate a similar disparity between the suppression of arrhythmia and sudden death or overall mortality, a phenomenon that was evident in the Cardiac Arrhythmia Suppression Trials.^13,14,21 No difference in overall mortality was found between the group of patients in whom ventricular arrhythmias were suppressed (those with 80 percent or greater suppression of premature ventricular contractions) and those in whom arrhythmias were not suppressed.

Because our study was conducted at various Veterans Affairs medical centers, most of the patients were men. The effect of antiarrhythmic therapy on mortality among women with congestive heart failure and arrhythmia is unknown.

A number of conclusions can be drawn from this double-blind, placebo-controlled study of amiodarone in patients with mild-to-moderate heart failure. The drug was well tolerated and effective in suppressing arrhythmias and improving ventricular function, but it did not reduce the frequency of sudden death or prolong survival. Its effects were not significantly influenced by the level of the left ventricular ejection fraction or the degree of suppression of premature ventricular contractions on Holter monitoring. However, there was a trend toward reduced overall mortality among patients with nonischemic cardiomyopathy, which merits further study.

Supported by the Department of Veterans Affairs Cooperative Studies Program of the Medical Research Service (Washington, D.C.), by Sanofi Winthrop Recherche (Paris), and by Wyeth-Ayerst Laboratories (Philadelphia).

We are indebted to Patricia Jones for her assistance in the preparation of the manuscript.

^* The institutions and investigators participating in the Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure are listed in the Appendix.

Source Information

From the Department of Cardiology, Veterans Affairs Medical Center, Washington, D.C. (S.N.S., R.D.F., D.L.); Veterans Affairs Cooperative Studies Coordinating Center, Hines, Ill., and Loyola University Medical Center, Maywood, Ill. (S.G.F.); the Department of Cardiology, Wadsworth Veterans Affairs Medical Center, Los Angeles (B.N.S.); the Department of Cardiology, Veterans Affairs Medical Center, Kansas City, Mo. (H.D.L.); the Department of Cardiology, Veterans Affairs Medical Center, Fresno, Calif. (P.C.D.); the Department of Cardiology, Veterans Affairs Medical Center, San Francisco (B.M.M.); and the Cooperative Studies Program, Veterans Affairs Medical Center, Albuquerque, N.M. (C.C.).

Address reprint requests to Dr. Singh at the Division of Cardiology, Veterans Affairs Medical Center 1E301, 50 Irving St., NW, Washington, DC 20422.

References

1. Cohn JN. Current therapy of the failing heart. Circulation 1988;78:1099-1107. [Free Full Text]
2. Cohn JN, Franciosa JA. Vasodilator therapy for cardiac failure. N Engl J Med 1977;297:27-31. [Medline]
3. Kulick DL, Rahimtoola SH. Current role of digitalis therapy in patients with congestive heart failure. JAMA 1991;265:2995-2997. [Free Full Text]
4. Packer M. Pathophysiological mechanisms underlying the effects of beta-adrenergic agonists and antagonists on functional capacity and survival in chronic heart failure. Circulation 1990;82:Suppl:177-188. 
5. Cohn JN, Johnson G, Ziesche S, et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med 1991;325:303-310. [Abstract]
6. Holmes J, Kubo SH, Cody RJ, Kligfield P. Arrhythmias in ischemic and nonischemic dilated cardiomyopathy: prediction of mortality by ambulatory electrocardiography. Am J Cardiol 1985;55:146-151. [CrossRef][Medline]
7. Meinertz TE, Hofmann T, Kasper W, et al. Significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy. Am J Cardiol 1984;53:902-907. [CrossRef][Medline]
8. von Olshausen K, Schafer A, Mehmel HC, Schwarz F, Senges J, Kubler W. Ventricular arrhythmia in idiopathic dilated cardiomyopathy. Br Heart J 1984;51:195-201. [Free Full Text]
9. Unverferth DV, Magorien RD, Moeschberger ML, Baker PB, Fetters JK, Leier CV. Factors influencing one-year mortality of dilated cardiomyopathy. Am J Cardiol 1984;54:147-152. [CrossRef][Medline]
10. Chatterjee K. Amiodarone in chronic heart failure. J Am Coll Cardiol 1989;14:1775-1776. [Medline]
11. Chakko CS, Gheorghiade M. Ventricular arrhythmias in severe heart failure: incidence, significance, and effectiveness of antiarrhythmic therapy. Am Heart J 1985;109:497-504. [CrossRef][Medline]
12. Cleland JGF, Dargie HJ, Findlay IN, et al. Clinical, haemodynamic and antiarrhythmic effects of long term treatment with amiodarone of patients in heart failure. Br Heart J 1987;57:436-445. [Free Full Text]
13. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989;321:406-412. [Abstract]
14. The Cardiac Arrhythmia Suppression Trial II Investigators. Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. N Engl J Med 1992;327:227-233. [Abstract]
15. Ceremuzynski L, Kleczar E, Krzeminska-Pakula M, et al. Effect of amiodarone on mortality after myocardial infarction: a double-blind, placebo-controlled pilot study. J Am Coll Cardiol 1992;20:1056-1062. [Abstract]
16. Pfisterer M, Kiowski W, Burckhardt D, Follath F, Burkart F. Beneficial effect of amiodarone on cardiac mortality in patients with asymptomatic complex ventricular arrhythmias after acute myocardial infarction and preserved but not impaired left ventricular function. Am J Cardiol 1992;69:1399-1402. [CrossRef][Medline]
17. Singh BN. Amiodarone: historical development and pharmacologic profile. Am Heart J 1983;106:788-797. [CrossRef][Medline]
18. Hohnloser SH, Klingenheben T, Singh BN. Amiodarone-associated proarrhythmic effects: a review with special reference to torsade de pointes tachycardia. Ann Intern Med 1994;121:529-535. [Free Full Text]
19. Singh SN, Fletcher RD, Fisher S, et al. Veterans Affairs Congestive Heart Failure Antiarrhythmic Trial. Am J Cardiol 1993;72:99F-102F. [CrossRef][Medline]
20. Herre JM, Sauve MJ, Malone P, et al. Long-term results of amiodarone therapy in patients with recurrent sustained ventricular tachycardia or ventricular fibrillation. J Am Coll Cardiol 1989;13:442-449. [Abstract]
21. Singh BN. Choice and chance in drug therapy of cardiac arrhythmias: technique versus drug-specific responses in evaluation of efficacy. Am J Cardiol 1993;72:114F-124F. [CrossRef][Medline]
22. Greene HL. The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle: CASCADE Investigators. Am J Cardiol 1993;72:70F-74F. [CrossRef][Medline]
23. Nicklas JM, McKenna WJ, Stewart RA, et al. Prospective, double-blind, placebo-controlled trial of low-dose amiodarone in patients with severe heart failure and asymptomatic frequent ventricular ectopy. Am Heart J 1991;122:1016-1021. [CrossRef][Medline]
24. Doval HC, Nul DR, Grancelli HO, Perrone SV, Bortman GR, Curiel R. Randomised trial of low-dose amiodarone in severe congestive heart failure. Lancet 1994;344:493-498. [CrossRef][Medline]
25. Hamer AW, Arkles LB, Johns JA. Beneficial effects of low dose amiodarone in patients with congestive cardiac failure: a placebo-controlled trial. J Am Coll Cardiol 1989;14:1768-1774. [Abstract]
26. Cingolani HE, Wiedman RT, Lynch JJ, et al. Negative lusitropic effect of DPI201-106 and E4031: possible role of prolonging action potential duration. J Mol Cell Cardiol 1990;22:1025-1034. [CrossRef][Medline]
27. Yusuf S, Teo K. Inotropic agents increase mortality in patients with congestive heart failure. Circulation 1990;82:Suppl:III-673.abstract 
28. Packer M, Carver JR, Rodeheffer RJ, et al. Effect of oral milrinone on mortality in severe chronic heart failure. N Engl J Med 1991;325:1468-1475. [Abstract]

The following Veterans Affairs medical centers and investigators participated in the Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure: Bronx, N.Y. -- P. Scweitzer and P. Patascil; Chicago, West Side -- J. Cumming and T. Redmond; Dallas -- P. Grayburn and S. Dougherty; Fresno, Calif. -- P.C. Deedwania and R. Kanefield; Jackson, Miss. -- T.N. Srivastava and T. King; Kansas City, Mo. -- D. Lewis and R. Corbett; Loma Linda, Calif. -- D.R. Ferry and K. Okubo; Long Beach, Calif. -- R. Wesley and S. Saniga; Louisville, Ky. -- A. Joseph and N. Zettwoch; Madison, Wis. -- P. Kosolcharoen and K. Cox; Miami -- C.S. Chakko and J. Johnson; Newington, Conn. -- M.J. Radford and D. Roth; North Chicago -- R. Singh and A. Skillman; Oklahoma City -- R. Lazzara and T. Deaton; Pittsburgh -- M. Amidi and J. Pulman; Providence, R.I. -- S. Sharma and E. Coccio; Richmond, Va. -- K.A. Ellenbogen and E. Early; Salem, Va. -- D. Russell and M. Judd; Salt Lake City -- R. Klein and L. Morrison; San Francisco -- B. Massie and E. Derr; Sepulveda, Calif. -- V.N. Udhoji and P. Pekale; Syracuse, N.Y. -- R. Warner and P. Lilja; Washington, D.C. -- R. Hall and D. Lazzeri; West Haven, Conn. -- I. Cohen and L. Canestri.

Cochairmen's office, Washington, D.C. -- S.N. Singh and R.D. Fletcher; Cooperative Studies Program Central Research Pharmacy, Albuquerque, N.M. -- M. Sather (chief) and C.L. Colling (study pharmacist); Central Holter Monitor Laboratory, Washington, D.C. -- R.D. Fletcher; nurse coordinator, Washington, D.C. -- D. Lazzeri; Hines Cooperative Studies Program Coordinating Center -- W.G. Henderson (chief), S. Gross Fisher (biostatistician), L. Weber (study programmer), and D. Cavello and M. Biondic (study coordinators).

Data and Safety Monitoring Board -- J.T. Bigger (chairman), J. Anderson, D. Echt, M. Packer, J. Morganroth, and G. Williams; Executive Committee -- S. Singh, R. Fletcher, S. Gross Fisher, P. Deedwania, D. Lewis, B. Massie, B.N. Singh, and C. Colling; Mortality Committee -- B.N. Singh (chairman), D. Lewis, S. Singh, and S. Gross Fisher; Department of Veterans Affairs Central Office -- D. Deykin (chief of Cooperative Studies Program), J. Gold (administrative officer), and P. Huang (staff assistant).

Abstract PDF Letters Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Related Letters:

Amiodarone in Congestive Heart Failure
Silver M. J., Young J., Topol E. J., Colli A., Sechi L. A., De Carli S., Bartoli E., Singh S. N., Fletcher R. D., Fisher S. G.
Extract | Full Text  
N Engl J Med 1995; 333:1639-1641, Dec 14, 1995. Correspondence

Implantable Defibrillators in Patients with Coronary Artery Disease at High Risk for Ventricular Arrhythmia
Clesham G. J., Petch M. C., Uretsky B. F., Moss A. J., Hall W. J., The MADIT Investigators
Extract | Full Text  
N Engl J Med 1997; 336:1676-1677, Jun 5, 1997. Correspondence

This article has been cited by other articles:

• Piccini, J. P., Berger, J. S., O'Connor, C. M. (2009). Amiodarone for the prevention of sudden cardiac death: a meta-analysis of randomized controlled trials. Eur Heart J 30: 1245-1253 [Abstract] [Full Text]  
• Hunt, S. A., Abraham, W. T., Chin, M. H., Feldman, A. M., Francis, G. S., Ganiats, T. G., Jessup, M., Konstam, M. A., Mancini, D. M., Michl, K., Oates, J. A., Rahko, P. S., Silver, M. A., Stevenson, L. W., Yancy, C. W. (2009). 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation. J Am Coll Cardiol 53: e1-e90 [Full Text]  
• Jessup, M., Abraham, W. T., Casey, D. E., Feldman, A. M., Francis, G. S., Ganiats, T. G., Konstam, M. A., Mancini, D. M., Rahko, P. S., Silver, M. A., Stevenson, L. W., Yancy, C. W. (2009). 2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation. J Am Coll Cardiol 53: 1343-1382 [Full Text]  
• 2009 WRITING GROUP TO REVIEW NEW EVIDENCE AND UPDA, , Jessup, M., Abraham, W. T., Casey, D. E., Feldman, A. M., Francis, G. S., Ganiats, T. G., Konstam, M. A., Mancini, D. M., Rahko, P. S., Silver, M. A., Stevenson, L. W., Yancy, C. W. (2009). 2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation. Circulation 119: 1977-2016 [Full Text]  
• 2005 WRITING COMMITTEE MEMBERS, , Hunt, S. A., Abraham, W. T., Chin, M. H., Feldman, A. M., Francis, G. S., Ganiats, T. G., Jessup, M., Konstam, M. A., Mancini, D. M., Michl, K., Oates, J. A., Rahko, P. S., Silver, M. A., Stevenson, L. W., Yancy, C. W. (2009). 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation. Circulation 119: e391-e479 [Full Text]  
• Authors/Task Force Members, , Dickstein, K., Cohen-Solal, A., Filippatos, G., McMurray, J. J.V., Ponikowski, P., Poole-Wilson, P. A., Stromberg, A., van Veldhuisen, D. J., Atar, D., Hoes, A. W., Keren, A., Mebazaa, A., Nieminen, M., Priori, S. G., Swedberg, K., ESC Committee for Practice Guidelines (CPG), , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Funck-Brentano, C., Hellemans, I., Kristensen, S. D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., Document Reviewers, , Tendera, M., Auricchio, A., Bax, J., Bohm, M., Corra, U., della Bella, P., Elliott, P. M., Follath, F., Gheorghiade, M., Hasin, Y., Hernborg, A., Jaarsma, T., Komajda, M., Kornowski, R., Piepoli, M., Prendergast, B., Tavazzi, L., Vachiery, J.-L., Verheugt, F. W. A., Zamorano, J. L., Zannad, F. (2008). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J 29: 2388-2442 [Full Text]  
• Dickstein, K., Cohen-Solal, A., Filippatos, G., McMurray, J. J.V., Ponikowski, P., Poole-Wilson, P. A., Stromberg, A., van Veldhuisen, D. J., Atar, D., Hoes, A. W., Keren, A., Mebazaa, A., Nieminen, M., Priori, S. G., Swedberg, K. (2008). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail 10: 933-989 [Full Text]  
• Mark, D. B., Anstrom, K. J., Sun, J. L., Clapp-Channing, N. E., Tsiatis, A. A., Davidson-Ray, L., Lee, K. L., Bardy, G. H., the Sudden Cardiac Death in Heart Failure Trial In, (2008). Quality of Life with Defibrillator Therapy or Amiodarone in Heart Failure. NEJM 359: 999-1008 [Abstract] [Full Text]  
• Kober, L., Torp-Pedersen, C., McMurray, J. J.V., Gotzsche, O., Levy, S., Crijns, H., Amlie, J., Carlsen, J., the Dronedarone Study Group, (2008). Increased Mortality after Dronedarone Therapy for Severe Heart Failure. NEJM 358: 2678-2687 [Abstract] [Full Text]  
• Kuner, R., Barth, A. S., Ruschhaupt, M., Buness, A., Zwermann, L., Kreuzer, E., Steinbeck, G., Poustka, A., Sultmann, H., Nabauer, M. (2008). Genomic analysis reveals poor separation of human cardiomyopathies of ischemic and nonischemic etiologies. Physiol. Genomics 34: 88-94 [Abstract] [Full Text]  
• Coceani, M. (2007). Use of Amiodarone. JAMA 298: 2617-2618 [Full Text]  
• Neuberger, H.-R., Mewis, C., van Veldhuisen, D. J., Schotten, U., van Gelder, I. C., Allessie, M. A., Bohm, M. (2007). Management of atrial fibrillation in patients with heart failure. Eur Heart J 28: 2568-2577 [Abstract] [Full Text]  
• Vassallo, P., Trohman, R. G. (2007). Prescribing Amiodarone: An Evidence-Based Review of Clinical Indications. JAMA 298: 1312-1322 [Abstract] [Full Text]  
• Singh, B. N., Aliot, E. (2007). Newer antiarrhythmic agents for maintaining sinus rhythm in atrial fibrillation: simplicity or complexity?. Eur Heart J Suppl 9: G17-G25 [Abstract] [Full Text]  
• Rehman, H. u., Kurnik, D., Loebstein, R., Olchovsky, D., Coceani, M., Skolnik, N., Armon, C., Zimetbaum, P. (2007). Amiodarone for Atrial Fibrillation. NEJM 356: 2424-2426 [Full Text]  
• Zimetbaum, P. (2007). Amiodarone for Atrial Fibrillation. NEJM 356: 935-941 [Full Text]  
• Wu, A. H (2007). Management of patients with non-ischaemic cardiomyopathy. Heart 93: 403-408 [Full Text]  
• Kirchhof, P., Breithardt, G., Eckardt, L. (2006). Primary prevention of sudden cardiac death. Heart 92: 1873-1878 [Full Text]  
• Gheorghiade, M., Sopko, G., De Luca, L., Velazquez, E. J., Parker, J. D., Binkley, P. F., Sadowski, Z., Golba, K. S., Prior, D. L., Rouleau, J. L., Bonow, R. O. (2006). Navigating the Crossroads of Coronary Artery Disease and Heart Failure. Circulation 114: 1202-1213 [Full Text]  
• Developed in Collaboration With the European Heart, , Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., Chaitman, B., Fromer, M., Gregoratos, G., Klein, G., Moss, A. J., Myerburg, R. J., Priori, S. G., Quinones, M. A., Roden, D. M., Silka, M. J., Tracy, C., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Antman, E. M., Anderson, J. L., Hunt, S. A., Halperin, J. L., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B., Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L. (2006). ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol 48: 1064-1108 [Full Text]  
• Developed in Collaboration With the European Heart, , Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., Chaitman, B., Fromer, M., Gregoratos, G., Klein, G., Moss, A. J., Myerburg, R. J., Priori, S. G., Quinones, M. A., Roden, D. M., Silka, M. J., Tracy, C., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Antman, E. M., Anderson, J. L., Hunt, S. A., Halperin, J. L., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B., Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L. (2006). ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol 48: e247-e346 [Full Text]  
• Zipes, D. P., Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., Chaitman, B., Fromer, M., Gregoratos, G., Klein, G., Moss, A. J., Myerburg, R. J., Priori, S. G., Quinones, M. A., Roden, D. M., Silka, M. J., Tracy, C., ESC Committee for Practice Guidelines, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L., ACC/AHA (Practice Guidelines) Task Force Members, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Antman, E. M., Anderson, J. L., Hunt, S. A., Halperin, J. L., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B. (2006). ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death--executive summary: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.. Eur Heart J 27: 2099-2140 [Full Text]  
• Writing Committee Members, , Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S., ACC/AHA Task Force Members, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B., ESC Committee for Practice Guidelines, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L. (2006). ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Europace 8: 651-745 [Full Text]  
• Writing Committee Members, , Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., Chaitman, B., Fromer, M., Gregoratos, G., Klein, G., Moss, A. J., Myerburg, R. J., Priori, S. G., Quinones, M. A., Roden, D. M., Silka, M. J., Tracy, C., ESC Committee for Practice Guidelines, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L., ACC/AHA Task Force Members, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Antman, E. M., Anderson, J. L., Hunt, S. A., Halperin, J. L., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B. (2006). ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Europace 8: 746-837 [Full Text]  
• Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S. (2006). ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society . J Am Coll Cardiol 48: 854-906 [Full Text]  
• Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S. (2006). ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society . J Am Coll Cardiol 48: e149-e246 [Full Text]  
• Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S., ACC/AHA TASK FORCE MEMBERS, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B., ESC COMMITTEE FOR PRACTICE GUIDELINES, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L. (2006). ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114: e257-e354 [Full Text]  
• Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S., ACC/AHA TASK FORCE MEMBERS, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B., ESC COMMITTEE FOR PRACTICE GUIDELINES, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L. (2006). ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114: 700-752 [Full Text]  
• Authors/Task Force Members, , Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S., ESC Committee for Practice Guidelines, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L., ACC/AHA (Practice Guidelines) Task Force Members, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B. (2006). ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation executive summary: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Eur Heart J 27: 1979-2030 [Full Text]  
• The International Liaison Committee on Resuscitati, (2006). The International Liaison Committee on Resuscitation (ILCOR) Consensus on Science With Treatment Recommendations for Pediatric and Neonatal Patients: Pediatric Basic and Advanced Life Support. Pediatrics 117: e955-e977 [Abstract] [Full Text]  
• (2005). Part 6: Pediatric Basic and Advanced Life Support. Circulation 112: III-73-III-90 [Full Text]  
• Testa, L., Biondi-Zoccai, G. G.L., Russo, A. D., Bellocci, F., Andreotti, F., Crea, F. (2005). Rate-control vs. rhythm-control in patients with atrial fibrillation: a meta-analysis. Eur Heart J 26: 2000-2006 [Abstract] [Full Text]  
• Singh, B. N. (2005). {beta}-Adrenergic Blockers as Antiarrhythmic and Antifibrillatory Compounds: An Overview. J CARDIOVASC PHARMACOL THER 10: S3-S14 [Abstract]  
• Reiffel, J. A. (2005). Drug and Drug-Device Therapy in Heart Failure Patients in the Post-COMET and SCD-HeFT Era. J CARDIOVASC PHARMACOL THER 10: S45-S58 [Abstract]  
• Kowey, P. R. (2005). A Review of Carvedilol Arrhythmia Data in Clinical Trials. J CARDIOVASC PHARMACOL THER 10: S59-S68 [Abstract]  
• Developed in Collaboration With the American Colle, , Endorsed by the Heart Rhythm Society, , Hunt, S. A., Abraham, W. T., Chin, M. H., Feldman, A. M., Francis, G. S., Ganiats, T. G., Jessup, M., Konstam, M. A., Mancini, D. M., Michl, K., Oates, J. A., Rahko, P. S., Silver, M. A., Stevenson, L. W., Yancy, C. W., Antman, E. M., Smith, S. C. Jr, Adams, C. D., Anderson, J. L., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Jacobs, A. K., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B. (2005). ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 46: 1116-1143 [Full Text]  
• Hunt, S. A., Abraham, W. T., Chin, M. H., Feldman, A. M., Francis, G. S., Ganiats, T. G., Jessup, M., Konstam, M. A., Mancini, D. M., Michl, K., Oates, J. A., Rahko, P. S., Silver, M. A., Stevenson, L. W., Yancy, C. W., Antman, E. M., Smith, S. C. Jr, Adams, C. D., Anderson, J. L., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Jacobs, A. K., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B. (2005). ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): Developed in Collaboration With the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: Endorsed by the Heart Rhythm Society. Circulation 112: 1825-1852 [Full Text]  
• Rubinstein, J., Zimetbaum, P. J., Josephson, M. E., Schlegel, A., Desai, K. R., Singh, B. N., Singh, S. N., Reda, D. (2005). Amiodarone versus sotalol for atrial fibrillation.. NEJM 353: 627-630 [Full Text]  
• Ioannidis, J. P. A. (2005). Contradicted and Initially Stronger Effects in Highly Cited Clinical Research. JAMA 294: 218-228 [Abstract] [Full Text]  
• Swedberg, K., Olsson, L. G., Charlesworth, A., Cleland, J., Hanrath, P., Komajda, M., Metra, M., Torp-Pedersen, C., Poole-Wilson, P. (2005). Prognostic relevance of atrial fibrillation in patients with chronic heart failure on long-term treatment with beta-blockers: results from COMET. Eur Heart J 26: 1303-1308 [Abstract] [Full Text]  
• Authors/Task Force Members, , Swedberg, K., Writing Committee:, , Cleland, J., Dargie, H., Drexler, H., Follath, F., Komajda, M., Tavazzi, L., Smiseth, O. A., Other Contributors, , Gavazzi, A., Haverich, A., Hoes, A., Jaarsma, T., Korewicki, J., Levy, S., Linde, C., Lopez-Sendon, J.-L., Nieminen, M. S., Pierard, L., Remme, W. J. (2005). Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 26: 1115-1140 [Full Text]  
• Kittleson, M. M., Minhas, K. M., Irizarry, R. A., Ye, S. Q., Edness, G., Breton, E., Conte, J. V., Tomaselli, G., Garcia, J. G. N., Hare, J. M. (2005). Gene expression analysis of ischemic and nonischemic cardiomyopathy: shared and distinct genes in the development of heart failure. Physiol. Genomics 21: 299-307 [Abstract] [Full Text]  
• Singh, B. N., Singh, S. N., Reda, D. J., Tang, X. C., Lopez, B., Harris, C. L., Fletcher, R. D., Sharma, S. C., Atwood, J. E., Jacobson, A. K., Lewis, H. D. Jr., Raisch, D. W., Ezekowitz, M. D., the Sotalol Amiodarone Atrial Fibrillation Efficac, (2005). Amiodarone versus Sotalol for Atrial Fibrillation. NEJM 352: 1861-1872 [Abstract] [Full Text]  
• Lane, R. E, Cowie, M. R, Chow, A. W C (2005). Prediction and prevention of sudden cardiac death in heart failure. Heart 91: 674-680 [Full Text]  
• Patwala, A Y, Wright, D J (2005). Device based treatment of heart failure. Postgrad. Med. J. 81: 286-291 [Abstract] [Full Text]  
• Tachikawa, H., Kodama, M., Watanabe, K., Takahashi, T., Ma, M., Kashimura, T., Ito, M., Hirono, S., Okura, Y., Kato, K., Hanawa, H., Aizawa, Y. (2005). Amiodarone Improves Cardiac Sympathetic Nerve Function to Hold Norepinephrine in the Heart, Prevents Left Ventricular Remodeling, and Improves Cardiac Function in Rat Dilated Cardiomyopathy. Circulation 111: 894-899 [Abstract] [Full Text]  
• Bardy, G. H., Lee, K. L., Mark, D. B., Poole, J. E., Packer, D. L., Boineau, R., Domanski, M., Troutman, C., Anderson, J., Johnson, G., McNulty, S. E., Clapp-Channing, N., Davidson-Ray, L. D., Fraulo, E. S., Fishbein, D. P., Luceri, R. M., Ip, J. H., the Sudden Cardiac Death in Heart Failure Trial (S, (2005). Amiodarone or an Implantable Cardioverter-Defibrillator for Congestive Heart Failure. NEJM 352: 225-237 [Abstract] [Full Text]  
• Yan, A. T., Yan, R. T., Liu, P. P. (2005). Narrative Review: Pharmacotherapy for Chronic Heart Failure: Evidence from Recent Clinical Trials. ANN INTERN MED 142: 132-145 [Abstract] [Full Text]  
• Katritsis, D. G, Camm, A.J. (2004). Nonsustained ventricular tachycardia: where do we stand?. Eur Heart J 25: 1093-1099 [Abstract] [Full Text]  
• Thompson, A., Balser, J. R. (2004). Perioperative cardiac arrhythmias. Br J Anaesth 93: 86-94 [Abstract] [Full Text]  
• Kadish, A., Dyer, A., Daubert, J. P., Quigg, R., Estes, N.A. M., Anderson, K. P., Calkins, H., Hoch, D., Goldberger, J., Shalaby, A., Sanders, W. E., Schaechter, A., Levine, J. H., the Defibrillators in Non-Ischemic Cardiomyopathy, (2004). Prophylactic Defibrillator Implantation in Patients with Nonischemic Dilated Cardiomyopathy. NEJM 350: 2151-2158 [Abstract] [Full Text]  
• Steinberg, J. S., Sadaniantz, A., Kron, J., Krahn, A., Denny, D. M., Daubert, J., Campbell, W. B., Havranek, E., Murray, K., Olshansky, B., O'Neill, G., Sami, M., Schmidt, S., Storm, R., Zabalgoitia, M., Miller, J., Chandler, M., Nasco, E. M., Greene, H. L., the AFFIRM Investigators, (2004). Analysis of Cause-Specific Mortality in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Study. Circulation 109: 1973-1980 [Abstract] [Full Text]  
• Amabile, C. M., Spencer, A. P. (2004). Keeping Your Patient With Heart Failure Safe: A Review of Potentially Dangerous Medications. Arch Intern Med 164: 709-720 [Full Text]  
• Pratt, C. M., Singh, S. N., Al-Khalidi, H. R., Brum, J. M., Holroyde, M. J., Marcello, S. R., Schwartz, P. J., Camm, A. J., ALIVE Investigators, (2004). The efficacy of azimilide in the treatment of atrial fibrillation in the presence of left ventricular systolic dysfunction: Results from the Azimilide Postinfarct Survival Evaluation (ALIVE) trial. J Am Coll Cardiol 43: 1211-1216 [Abstract] [Full Text]  
• Ruo, B., Capra, A. M., Jensvold, N. G., Go, A. S. (2004). Racial variation in the prevalence of atrial fibrillation among patients with heart failure: the Epidemiology, Practice, Outcomes, and Costs of Heart Failure (EPOCH) study. J Am Coll Cardiol 43: 429-435 [Abstract] [Full Text]  
• Curtis, A. B. (2004). Filling the need for new antiarrhythmic drugs to prevent shocks from implantable cardioverter defibrillators. J Am Coll Cardiol 43: 44-46 [Full Text]  
• Antezano, E. S., Hong, M. (2003). Sudden Cardiac Death. J Intensive Care Med 18: 313-329 [Abstract]  
• Bode-Schnurbus, L, Bocker, D, Block, M, Gradaus, R, Heinecke, A, Breithardt, G, Borggrefe, M (2003). QRS duration: a simple marker for predicting cardiac mortality in ICD patients with heart failure. Heart 89: 1157-1162 [Abstract] [Full Text]  
• Gould, P. A, Esler, M. D, Kaye, D. M (2003). Chronic atrial fibrillation does not influence the magnitude of sympathetic overactivity in patients with heart failure. Eur Heart J 24: 1657-1662 [Abstract] [Full Text]  
• Singh, B. N. (2003). More on Amiodarone-Meeting the Challenges of the Combined Epidemics of Heart Failure and Atrial Fibrillation?. J CARDIOVASC PHARMACOL THER 8: 175-178  
• Cheung, A. T., Weiss, S. J., Savino, J. S., Levy, W. J., Augoustides, J. G., Harrington, A., Gardner, T. J. (2003). Acute circulatory actions of intravenous amiodarone loading in cardiac surgical patients. Ann. Thorac. Surg. 76: 535-541 [Abstract] [Full Text]  
• Strickberger, S. A., Hummel, J. D., Bartlett, T. G., Frumin, H. I., Schuger, C. D., Beau, S. L., Bitar, C., Morady, F., AMIOVIRT Investigators, (2003). Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemicdilated cardiomyopathy and asymptomaticnonsustained ventricular tachycardia--AMIOVIRT. J Am Coll Cardiol 41: 1707-1712 [Abstract] [Full Text]  
• Jayachandran, J. V., Zipes, D. P. (2003). Say no to primary prophylaxis with implantable cardioverter-defibrillators in asymptomatic nonischemic dilated cardiomyopathy?. J Am Coll Cardiol 41: 1713-1715 [Full Text]  
• Lee, D. S., Green, L. D., Liu, P. P., Dorian, P., Newman, D. M., Grant, F. C., Tu, J. V., Alter, D. A. (2003). Effectiveness of implantable defibrillators for preventing arrhythmic events and death: A Meta-Analysis. J Am Coll Cardiol 41: 1573-1582 [Abstract] [Full Text]  
• Farre, J., Nisam, S. (2003). Response to the letter to the editor (Sharma et al.). Eur Heart J 24: 880-881 [Full Text]  
• Kirchhof, P., Degen, H., Franz, M. R., Eckardt, L., Fabritz, L., Milberg, P., Laer, S., Neumann, J., Breithardt, G., Haverkamp, W. (2003). Amiodarone-Induced Postrepolarization Refractoriness Suppresses Induction of Ventricular Fibrillation. J. Pharmacol. Exp. Ther. 305: 257-263 [Abstract] [Full Text]  
• Felker, G. M., Benza, R. L., Chandler, A. B., Leimberger, J. D., Cuffe, M. S., Califf, R. M., Gheorghiade, M., O'Connor, C. M., OPTIME-CHF Investigators, (2003). Heart failure etiology and response tomilrinone in decompensated heart failure: Results from the OPTIME-CHF study. J Am Coll Cardiol 41: 997-1003 [Abstract] [Full Text]  
• Brendorp, B, Torp-Pedersen, C, Elming, H, Kober, L, for the DIAMOND study group, (2003). Survival after withdrawal of dofetilide in patients with congestive heart failure and a short baseline QTc interval: A follow-up on the Diamond-CHF QT substudy. Eur Heart J 24: 274-279 [Abstract] [Full Text]  
• Jessup, M. (2003). The less familiar face of heart failure. J Am Coll Cardiol 41: 224-226 [Full Text]  
• Moss, A.J. (2003). MADIT-II and its implications. Eur Heart J 24: 16-18 [Full Text]  
• Donaldson, R. M. Jr., Stecker, E. C., Pollack, H. A., Carbajal, E. V., Smith, R. G., Cohen, S. E., Gollapudi, A. K., Spivack, C., Moss, A. J., Hall, W. J., Zareba, W. (2002). Implantable Cardiac Defibrillators. NEJM 347: 365-367 [Full Text]  
• Fung, J. W.H., Chan, S. K.W., Yeung, L. Y.C., Sanderson, J. E. (2002). Is beta-blockade useful in heart failure patients with atrial fibrillation? An analysis of data from two previously completed prospective trials. Eur J Heart Fail 4: 489-494 [Abstract] [Full Text]  
• Allot, E, de Chillou, C, Sadoul, N (2002). Ventricular instability and sudden death in patients with heart failure: lessons from clinical trials. Eur Heart J Suppl 4: D31-D42 [Abstract]  
• Zannad, F (2002). Evidence-based drug therapy for chronic heart failure. Eur Heart J Suppl 4: D66-D72 [Abstract]  
• Deng, M.C, Ascheim, D.D, Edwards, N.M, Naka, Y (2002). End-stage heart failure: which options?. Eur Heart J Suppl 4: D122-D130 [Abstract]  
• POPPAS, A., ROUNDS, S. (2002). Congestive Heart Failure. Am. J. Respir. Crit. Care Med. 165: 4-8 [Full Text]  
• Sanoski, C. A., Bauman, J. L. (2002). Clinical Observations With the Amiodarone/Warfarin Interaction : Dosing Relationships With Long-term Therapy. Chest 121: 19-23 [Abstract] [Full Text]  
• van Opstal, J. M., Schoenmakers, M., Verduyn, S. C., de Groot, S.H. M., Leunissen, J. D.M., van der Hulst, F. F., Molenschot, M. M.C., Wellens, H. J.J., Vos, M. A. (2001). Chronic Amiodarone Evokes No Torsade de Pointes Arrhythmias Despite QT Lengthening in an Animal Model of Acquired Long-QT Syndrome. Circulation 104: 2722-2727 [Abstract] [Full Text]  
• Huikuri, H. V., Castellanos, A., Myerburg, R. J. (2001). Sudden Death Due to Cardiac Arrhythmias. NEJM 345: 1473-1482 [Full Text]  
• (2001). Guidelines for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to develop guidelines for the management of patients with atrial fibrillation) developed in collaboration with the North American Society of Pacing and Electrophysiology. Eur Heart J 22: 1852-1923  
• Fuster, V., Ryden, L. E., Asinger, R. W., Cannom, D. S., Crijns, H. J., Frye, R. L., Halperin, J. L., Kay, G. N., Klein, W. W., Levy, S., McNamara, R. L., Prystowsky, E. N., Wann, L. S., Wyse, D. G., Gibbons, R. J., Antman, E. M., Alpert, J. S., Faxon, D. P., Fuster, V., Gregoratos, G., Hiratzka, L. F., Jacobs, A. K., Russell, R. O., Smith, S. C. Jr, Klein, W. W., Alonso-Garcia, A., Blomstrom-Lundqvist, C., De Backer, G., Flather, M., Hradec, J., Oto, A., Parkhomenko, A., Silber, S., Torbicki, A. (2001). ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology. J Am Coll Cardiol 38: 1266-1266 [Full Text]  
• Cleland, J. G F, John, J., Dhawan, J., Clark, A. (2001). What is the optimal medical management of ischaemic heart failure?. Br Med Bull 59: 135-158 [Abstract] [Full Text]  
• Task Force for the Diagnosis and Treatment of Chro, , Remme, W. J., Swedberg, K. (2001). Guidelines for the diagnosis and treatment of chronic heart failure. Eur Heart J 22: 1527-1560  
• Priori, S.G., Aliot, E., Blomstrom-Lundqvist, C., Bossaert, L., Breithardt, G., Brugada, P., Camm, A.J., Cappato, R., Cobbe, S.M., Di Mario, C., Maron, B.J., McKenna, W.J., Pedersen, A.K., Ravens, U., Schwartz, P.J., Trusz-Gluza, M., Vardas, P., Wellens, H.J.J., Zipes, D.P. (2001). Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J 22: 1374-1450  
• Azpitarte, J., Baun, O., Moreno, E., Garcia-Orta, R., Sanchez-Ramos, J., Tercedor, L. (2001). In Patients With Chronic Atrial Fibrillation and Left Ventricular Systolic Dysfunction, Restoration of Sinus Rhythm Confers Substantial Benefit. Chest 120: 132-138 [Abstract] [Full Text]  
• Falk, R. H. (2001). Atrial Fibrillation. NEJM 344: 1067-1078 [Full Text]  
• Martino, E., Bartalena, L., Bogazzi, F., Braverman, L. E. (2001). The Effects of Amiodarone on the Thyroid. Endocr. Rev. 22: 240-254 [Abstract] [Full Text]  
• Nanas, J. N., Kontoyannis, D. A., Alexopoulos, G. P., Anastasiou-Nana, M. I., Tsagalou, E. P., Stamatelopoulos, S. F., Moulopoulos, S. D. (2001). Long-term Intermittent Dobutamine Infusion Combined With Oral Amiodarone Improves the Survival of Patients With Severe Congestive Heart Failure. Chest 119: 1173-1178 [Abstract] [Full Text]  
• Brendorp, B., Elming, H., Jun, L., Kober, L., Malik, M., Jensen, G. B., Torp-Pedersen, C. (2001). QTc Interval as a Guide to Select Those Patients With Congestive Heart Failure and Reduced Left Ventricular Systolic Function Who Will Benefit From Antiarrhythmic Treatment With Dofetilide. Circulation 103: 1422-1427 [Abstract] [Full Text]  
• Singh, B. N., Sarma, J. S. M. (2001). Mechanisms of Action of Antiarrhythmic Drugs Relative to the Origin and Perpetuation of Cardiac Arrhythmias. J CARDIOVASC PHARMACOL THER 6: 69-87