Do antiarrhythmic agents prevent sudden death in patients with heart failure?
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Do antiarrhythmic agents prevent sudden death in patients with heart failure? Bottom line: Amiodarone and beta-blockers reduce sudden cardiac death (SCD) in a heterogeneous population of patients with heart failure (HF), acute myocardial infarction (AMI), and ventricular arrhythmias. However, only beta-blockers are associated with a reduction in all-cause mortality (SOR: A, meta-analyses of high-quality RCTs). In patients selected specifically for HF (NYHA class II and III), amiodarone has no effect on 5-year all-cause mortality and increases mortality in the subgroup of patients with just NYHA class III congestive heart failure (CHF) (SOR: B, single high-quality RCT). Implantable cardioverter defibrillators (ICDs) reduce all-cause mortality in HF patients and are better tolerated than amiodarone (SOR: B, high-quality RCT).
Evidence-based practice 20, no. 1 (2017): 15