Therapy

Give iv amiodarone (initial rapid infusion - 150 mg over 10 mins; loading infusion - 1 mg/min for 6 hours; maintenance infusion - 0.52 mg/min for the remainder of 48 hours) ^a

Why?

• High-dose amiodarone is more effective than bretylium at reducing further haemodynamically destabilising VT or VF (on average one fewer per 2 hours), and causes fewer adverse effects ^a

High-dose amiodarone causes fewer adverse effects than bretylium

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
recurrent or continuous VT or VF a	high-dose amiodarone	bretylium	adverse effects at 48 hours	58%	28% (5% to 46%)	6 (3 to 34)