A few studies and a meta-analysis of several large studies have shown a reduction in SCD using ami- odarone in patients with LV dysfunction due to prior MI and NICM,S5.1.5.2-21 S5.1.5.2-23 but SCD-HeFT showed no survival benefit from amiodarone compared with A secondary analysis of the SCD-HeFT showed increased risk of mortality with amiodarone in patients with New York Heart Association (NYHA) class A systematic review of the litera- ture in high-risk patients (LVEF <40%, with or without coronary disease), concluded that, for primary preven- tion, amiodarone, compared with no treatment or pla- cebo, decreased the risk of SCD (Risk ratio: 0.76; 95% CI: 0.66 0.88) and all-cause mortality (Risk ratio: 0.88; 95% CI: 0.78 1.00), but the quality of the supporting evidence was very low.S5.1.5.2-26 For secondary prevention of SCD, the same systematic review identified neither risk nor benefit with amiodarone.S5.1.5.2-26 Compared with beta-blocker therapy and other antiarrhythmic medications (including sotalol), amiodarone appears to reduce the risk of SCD and all-cause mortality.S5.1.5.2-26 Intravenous amiodarone has a role in reducing recur- rent VF/VF during resuscitation.S5.1.5.2-3,S5.1.5.2-27 S5.1.5.2-29 Chronic administration of amiodarone is associated with complex medication interactions and a host of adverse effects involving the lung, liver, thyroid, skin, and nervous system. As a general rule, the longer the therapy and the higher dose of amiodarone, the great- er the likelihood of adverse effects that will require Verapamil (IV) IV: 2.5 5 mg q 15 30 min Sustained release PO: VT (specifically RVOT, verapamil- sensitive idiopathic LVT) ICa-L Sinus rate slowed PR prolonged AV nodal conduction slowed : 3 7 h Metab: H Excr: U Cardiac: Hypotension, edema, HF, AVB, bradycardia, exacerbation of HFrEF Other: Headache, rash, gingival hyperplasia, constipation, dyspepsia *Although up to 800 mg every 8 h might be used, higher doses of amiodarone are associated with a higher risk of adverse events. 