Our use of amiodarone in 200 patients during an 8-year period confirms our previous experience which indicated that the drug was close to being the ideal antiarrhythmic agent in children's arrhythmias. Its absence of cardiac toxicity, its powerful antiarrhythmic properties, its depressive effect on the AV nodal conduction, combined with its beta-inhibitory effect makes it effective and harmless in practically all forms of atrial, junctional and ventricular arrhythmias, whatever the reentrant or automatic mechanism of the arrhythmia. The metabolism is much faster in children than in adults, making the drug active in a few hours, with a lesser prolonged duration of action. Though there is practically no limitation for its use on a short- or mean-term basis, the long-term use must be limited to truly refractory arrhythmias, a situation which is rarely encountered. In such cases, combining amiodarone with conventional therapy allows a decrease in the maintenance dosage and a lower incidence of extracardiac side effects.