Amiodarone acts by
- Correcting the rhythm to sinus .
- Controls ventricular rate alone
- Does both ?
Answer is 3
How can it correct the rhythm alone ? If the rhythm is corrected , rate will automatically be controlled, unless Amiodarone converts AF into Sinus tachycardia which is very unlikely !
Of course Amidarone is not a magic drug .The success rate of Amiodarone restoring sinus rhythm is far . . . far less . . . than our expectations ! . It fails to convert to sinus rhythm in a significant chunk *. Interestingly , it may still control the ventricular response by its beta blocking action .
*Our estimate is , the failure rate Amiodarone is between 30-40% or even higher , as bulk of AF we witness is due to Rheumatic heart disease.
Dr.S.Venkatesan MD 