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May 17, 1995

Pharmacologic Treatment of Congestive Heart Failure-Reply

Author Affiliations

New England Medical Center Boston, Mass
Emory University School of Medicine Atlanta, Ga

JAMA. 1995;273(19):1492. doi:10.1001/jama.1995.03520430027029

In Reply.  —We appreciate the comments of Dr Ahmad, Dr Anderson, and Dr Oosterbosch, expressed in an effort to improve the recommendations within the recent Agency for Health Care Policy and Research clinical practice guideline on heart failure1 and in our recent publication in The Journal.Ahmad raises the potential value of low-dose amiodarone. At this time, we do not believe that sufficient data exist to reach a consensus regarding the role of low-dose amiodarone for prolonging survival in heart failure. Currently available data are conflicting. A promising study, showing improved survival with amiodarone,2 was published subsequent to the publication of the guideline. However, the study by Nicklas et al3 referenced by Ahmad showed no clinical benefit. We believe that more data are needed to determine whether routine use of this agent is warranted.We concur with the comments of Anderson regarding the importance of magnesium replacement

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