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Implantable cardioverter defibrillator (ICD) shocks are painful. Defining effective antiarrhythmic pharmacotherapy could reduce the number of appropriate and inappropriate shocks delivered. Connolly and colleaguesArticle report results of the Optimal Pharmacological Therapy in Cardioverter Defibrillator Patients (OPTIC) Trial, which assessed whether 1 year of treatment with amiodarone plus β-blocker (metoprolol, carvedilol, or bisoprolol) or sotalol would be better than β-blocker alone for prevention of shocks in patients with a new ICD. The investigators found a reduced incidence of shocks in patients who were randomly assigned to either amiodarone plus β-blocker or sotalol compared with patients assigned to β-blocker alone. In an editorial, PageArticle discusses interactions of antiarrhythmic drug therapy with an ICD and potential benefits and risks of combined therapy.
This Week in JAMA . JAMA. 2006;295(2):131. doi:10.1001/jama.295.2.131
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