Amiodarone is recommended for shock-refractory ventricular arrhythmia during\nresuscitation; however, it is unknown whether amiodarone is effective for preventing ventricular\narrhythmia recurrence in out-of-hospital cardiac arrest (OHCA) survivors treated with targeted\ntemperature management (TTM). We investigated the effectiveness of prophylactic amiodarone\nin preventing ventricular arrhythmia recurrence in OHCA survivors. Data of consecutive adult\nnon-traumatic OHCA survivors treated with TTM between 2010 and 2016 were extracted from\nprospective cardiac arrest registries of four tertiary care hospitals. The prophylactic amiodarone\ngroup was matched in a 1:1 ratio by using propensity scores. The primary outcome was\nventricular arrhythmia recurrence requiring defibrillation during TTM. Among 295 patients with an\ninitially shockable rhythm and 149 patients with initially non-shockable-turned-shockable rhythm,\n124 patients (27.9%) received prophylactic amiodarone infusion. The incidence of ventricular\narrhythmia recurrence was 11.26% (50/444). Multivariate analysis showed prophylactic amiodarone\ntherapy to be the independent factor associated with ventricular arrhythmia recurrence (odds ratio\n1.95, 95% CI 1.04-3.65, p = 0.04), however, no such association was observed (odds ratio 1.32,\n95% CI 0.57-3.04, p = 0.51) after propensity score matching. In this propensity-score-matched study,\nprophylactic amiodarone infusion had no effect on preventing ventricular arrhythmia recurrence in\nOHCA survivors with shockable cardiac arrest. Prophylactic amiodarone administration must be\nconsidered carefully.
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