Comparison of the effect of amiodarone and benziodarone on thyroxine metabolism and surface ECG.

Abstract

This study examined whether or not the electrophysiological effect of amiodarone on the heart is mediated through its action on thyroxine metabolism. Serum thyroid hormones and ECG were evaluated before and serially during amiodarone (15 subjects) and benziodarone (15 subjects) administration. Both amiodarone and benziodarone shifted the peripheral conversion of thyroxine (P less than 0.001 for amiodarone and P less than 0.001 for benziodarone) towards reverse triiodothyronine and away from triiodothyronine, whilst TSH levels initially fell and then rose with both drugs. After amiodarone the heart rate decreased (P less than 0.025), whilst the PR (P less than 0.005) and the QT interval (P less than 0.005) corrected for the heart rate increased. By contrast with benziodarone only the PR interval decreased (P less than 0.05). Since both drugs had roughly similar effects on thyroid hormone metabolism but different ones on the ECG, our results provide indirect evidence against the hypothesis that the antiarrhythmic effects of amiodarone are mediated through a decrease in the serum T3 presented to the peripheral tissues.