Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia--AMIOVIRT

J Am Coll Cardiol. 2003 May 21;41(10):1707-12. doi: 10.1016/s0735-1097(03)00297-3.


Objectives: The purpose of this multicenter randomized trial was to compare total mortality during therapy with amiodarone or an implantable cardioverter-defibrillator (ICD) in patients with nonischemic dilated cardiomyopathy (NIDCM) and nonsustained ventricular tachycardia (NSVT).

Background: Whether an ICD reduces mortality more than amiodarone in patients with NIDCM and NSVT is unknown.

Methods: One hundred three patients with NIDCM, left ventricular ejection fraction < or =0.35, and asymptomatic NSVT were randomized to receive either amiodarone or an ICD. The primary end point was total mortality. Secondary end points included arrhythmia-free survival, quality of life, and costs.

Results: The study was stopped when the prospective stopping rule for futility was reached. The percent of patients surviving at one year (90% vs. 96%) and three years (88% vs. 87%) in the amiodarone and ICD groups, respectively, were not statistically different (p = 0.8). Quality of life was also similar with each therapy (p = NS). There was a trend with amiodarone, as compared to the ICD, towards improved arrhythmia-free survival (p = 0.1) and lower costs during the first year of therapy ($8,879 US dollars vs. $22,039 US dollars, p = 0.1).

Conclusions: Mortality and quality of life in patients with NIDCM and NSVT treated with amiodarone or an ICD are not statistically different. There is a trend towards a more beneficial cost profile and improved arrhythmia-free survival with amiodarone therapy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amiodarone / adverse effects
  • Amiodarone / economics
  • Amiodarone / therapeutic use*
  • Anti-Arrhythmia Agents / adverse effects
  • Anti-Arrhythmia Agents / economics
  • Anti-Arrhythmia Agents / therapeutic use*
  • Cardiomyopathy, Dilated / complications*
  • Cardiomyopathy, Dilated / economics
  • Cardiomyopathy, Dilated / mortality
  • Costs and Cost Analysis
  • Defibrillators, Implantable* / adverse effects
  • Defibrillators, Implantable* / economics
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Survival Rate
  • Tachycardia, Ventricular / complications
  • Tachycardia, Ventricular / economics
  • Tachycardia, Ventricular / mortality
  • Tachycardia, Ventricular / prevention & control*


  • Anti-Arrhythmia Agents
  • Amiodarone