Amiodarone is recommended for
shock-refractory ventricular
arrhythmia during
resuscitation; however, it is unknown whether
amiodarone is effective for preventing ventricular
arrhythmia recurrence in
out-of-hospital cardiac arrest (OHCA) survivors treated with
targeted temperature management (TTM). We investigated the effectiveness of prophylactic
amiodarone in preventing ventricular
arrhythmia recurrence in OHCA survivors. Data of consecutive adult non-traumatic OHCA survivors treated with TTM between 2010 and 2016 were extracted from prospective
cardiac arrest registries of four tertiary care hospitals. The prophylactic
amiodarone group was matched in a 1:1 ratio by using propensity scores. The primary outcome was ventricular
arrhythmia recurrence requiring defibrillation during TTM. Among 295 patients with an initially shockable rhythm and 149 patients with initially non-shockable-turned-shockable rhythm, 124 patients (27.9%) received prophylactic
amiodarone infusion. The incidence of ventricular
arrhythmia recurrence was 11.26% (50/444). Multivariate analysis showed prophylactic
amiodarone therapy to be the independent factor associated with ventricular
arrhythmia recurrence (odds ratio 1.95, 95% CI 1.04⁻3.65, p = 0.04), however, no such association was observed (odds ratio 1.32, 95% CI 0.57⁻3.04, p = 0.51) after propensity score matching. In this propensity-score-matched study, prophylactic
amiodarone infusion had no effect on preventing ventricular
arrhythmia recurrence in OHCA survivors with shockable
cardiac arrest. Prophylactic
amiodarone administration must be considered carefully.