Conference Proceeding - Restricted Access
Journal of the American College of Cardiology
Background: Amiodarone is a commonly used anti-arrhythmic drug in the elderly. The effect of amiodarone therapy in patients with pre-existing cardiac implantable electronic devices (CIEDs) undergoing transcatheter aortic valve replacement (TAVR) is not previously reported Methods: We retrospectively reviewed patients with pre-existing CIEDs undergoing TAVR at a large tertiary care hospital. Patients were grouped based on amiodarone exposure perioperatively (Am) vs no exposure (NoAm). Multivariate Cox-proportional Hazard ratio and Kaplan Meier curves were generated to evaluate mortality in these two groups Results: Of the 865 patients who underwent TAVR from 2012 to 2020, 113 patients (13.1%) had pre-existing CIEDs prior to TAVR. Am consisted of 15 (13.3%) patients (mean age 82.4 ± 10.5, 53.3% males) while NoAm included 98 (86.7%) patients (mean age 83.1 ± 9.4, 56% males). Atrial fibrillation was present in 86.7% of Am vs 65.3% of NoAm (P= 0.1751). Amiodarone use was associated with increased mortality after adjusting for baseline characteristics and presence of atrial fibrillation (HR 2.38, CI 1.19-4.75, P= 0.0138), with a median survival of 29 months in Am group versus 60 months in NoAm (P=0.005). Conclusion: Amiodarone use was independently associated with increased mortality in patients with CIEDs undergoing TAVR.
Madanat L, Seeley E, Shah K, Haines DE, Mehta N. Effect of amiodarone use in patients with pre-existing cardiac implantable electronic devices undergoing transcatheter aortic valve replacement. J Am Coll Cardiol. 2022 Mar 8;79(9 Suppl):208.