Heart drug may lead to pacemaker use in women

By Staff
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NEW YORK, Aug 14 (Reuters) A serious side effect of the heart drug amiodarone, sold under the trade name Cordarone, appears to affect women, but not men.

Amiodarone, which is used to treat a common heartbeat abnormality, increases the odds that a pacemaker will be needed in women, but not in men, new research suggests.

Atrial fibrillation is a heartbeat disturbance in which the walls of the upper chambers of the heart vibrate rapidly. This ''arrhythmia'' raises the risk that clots may form in the heart and possibly travel to the brain, causing a stroke. For this reason, patients are often treated with blood thinners to prevent these clots from forming.

Dr. Peter Zimetbaum and associates note in the Archives of Internal Medicine that amiodarone is more effective than other drugs for maintaining a normal heartbeat in patients with atrial fibrillation, but this comes at the cost of more side effects.

Zimetbaum, from Beth Israel Deaconess Medical Center in Boston, and colleagues evaluated the outcomes of 973 patients who were newly diagnosed with atrial fibrillation. The average age was 66 years, and 40 percent were female.

During an average follow-up of 2 years, 46 men and 39 women underwent the placement of a permanent pacemaker because of a slow heartbeat.

Amiodarone use was identified as a risk factor for requiring a pacemaker. However, further analysis showed that this only applied to women not to men. Women who used amiodarone were nearly five times more likely to require a pacemaker than those who did not.

The authors warn that ''additional caution should be taken when amiodarone is being prescribed to women.'' They advise using lower doses in women, ''particularly elderly women, because age is also associated with an increased need for pacemaker insertion.'' REUTERS CS VC0950

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