Heart failure is a complex clinical syndrome that may lead to sudden cardiac death. Several trials have studied whether the antiarrhythmic agent amiodarone reduces such mortality in heart failure,1 and two trials in particular have been at the centre of the debate: GESICA and CHF-STAT. It is important to remember past negative experiences with antiarrhythmic agents as well as the recent discontinuation of the ANDROMEDA trial owing to greater mortality associated with use of dronedarone, a non-iodinated derivative of amiodarone, in patients affected by left ventricular ventricular dysfuntion. On the basis of all of these considerations we believe that a further large scale, prospective trial is warranted to evaluate the safety of amiodarone in heart failure.
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