Cordarone & Side Effects

[Marty__0]

  My 71-year old father had a major heart attack at age 56.  He survived and was quite healthy until 2 years ago, when he suffered an episode of tachycardia with a heartbeat around 200/min.  His physician implanted a defibrillator.  He was fine for 4 months or so, but later it was felt that scar tissue from that episode made him worse, and he was put on a lot of drugs.  None helped, some hurt, until cordarone.  This was very effective in controlling the arrythmia, but suppressed his appetite, made him lethargic, and caused his hands to shake.  A tolerable dosage level was found.  In April, he had pneumonia & more tachycardia back-to-back.  He was put on a very high dose of amiodarone, leaving him effectively an invalid.  Finally, a catheter ablation was done, and the cordarone was scaled back but not eliminated.  In the last two weeks, he was hospitalized again with pneumonia, and the cordarone was eliminated.  Did the cordarone damage his lungs?  If so, is the damage reversible?  He now has a 24-hour oxygen feed; is this likely to be a continuing need?
---------------------------------------------------------------------------------------------------
Dear Marty:
Amiodarone can cause many side effects.  Pulmonary fibrosis is the most serious side effect of long term amiodarone use, more common with higher doses.  Pulmonary fibrosis is a process of scarring of the lungs.  Stopping amiodarone can keep the disease from progressing, but what damage is done is often irreversible.  I cannot say from the information you provided whether your father has pulmonary fibrosis, but it is high on the list of concerns.  It would be best for a pulmonologist [a lung doctor] to consult on the case to determine whether pulmonary fibrosis has occurred, or whether something else [that is treatable] is going on.  Perhaps some other drug could be used instead of the amiodarone, but your cardiologist would have to determine this - do not stop the amiodarone without checking with the cardiologist.
I hope this infomation is useful.  Good luck.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiac electrophysiologist at Desk F15.