Volume 10, Issue 2 (4-2024)
Journal of Research in Applied and Basic Medical Sciences 2024, 10(2): 121-129 |
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Maria R, Shah R, Pandya H, Kumar A, Patel R. Effect of prophylactic single dose parenteral amiodarone in mitral valve replacement surgery. Journal of Research in Applied and Basic Medical Sciences 2024; 10 (2) :121-129
URL: http://ijrabms.umsu.ac.ir/article-1-316-en.html
URL: http://ijrabms.umsu.ac.ir/article-1-316-en.html
Professor, Department of Cardiac Anesthesia, U N Mehta Institute of Cardiology and Research Center, India (Corresponding Author) , rbshah76@gmail.com
Abstract: (100 Views)
Background & Aims: Amiodarone is a purposive medicine useful in restoring sinus rhythm (SR) after cardiac surgery. The aim of the study was to evaluate the effect of prophylactic intraoperative single-dose intravenous amiodarone and to convert atrial fibrillation (AF) into normal sinus rhythm (NSR) in the patients undergoing valve replacement surgery.
Materials & Methods: In this prospective and interventional study, 180 patients of ASA III (American Society of Anesthesiologist) classification between the ages of 18-60 years, posted for Rheumatic Mitral Valve Replacement were allocated randomly to two equal groups (Group-1 and Group-2). Their hemodynamics parameters, Pre and post pulse rate, ECG findings and incidence of AF and VT/VF and ICU, Hospital stay were noted. Data was analysed with SPSS v26 using chi-square test. A two-tailed P value of 0.05 or less was regarded as statistically significant.
Results: In our study, we found that there was suggestive significance between both groups as regard to mean pulse rate changes after 5 and 10 minutes of induction (P value >0.05). At the end of surgery, there was developing atrial fibrillation in few patients and sinus rhythm in more (P value >0.05). Postoperative arrhythmias in the first 24 hrs, AF was seen in 9(10%) patients in the Group 1 compare to Group 2 49 (54.4%) (P <0.001). In both groups as regard to Mechanical ventilation & ICU stay was of suggestive significance in amiodarone group (P value <0.0001).
Conclusion: The incidence of post-operative AF among high-risk patients was significantly reduced by a prophylactic amiodarone treatment resulting in a shorter time of intensive care unit and hospital stay.
Materials & Methods: In this prospective and interventional study, 180 patients of ASA III (American Society of Anesthesiologist) classification between the ages of 18-60 years, posted for Rheumatic Mitral Valve Replacement were allocated randomly to two equal groups (Group-1 and Group-2). Their hemodynamics parameters, Pre and post pulse rate, ECG findings and incidence of AF and VT/VF and ICU, Hospital stay were noted. Data was analysed with SPSS v26 using chi-square test. A two-tailed P value of 0.05 or less was regarded as statistically significant.
Results: In our study, we found that there was suggestive significance between both groups as regard to mean pulse rate changes after 5 and 10 minutes of induction (P value >0.05). At the end of surgery, there was developing atrial fibrillation in few patients and sinus rhythm in more (P value >0.05). Postoperative arrhythmias in the first 24 hrs, AF was seen in 9(10%) patients in the Group 1 compare to Group 2 49 (54.4%) (P <0.001). In both groups as regard to Mechanical ventilation & ICU stay was of suggestive significance in amiodarone group (P value <0.0001).
Conclusion: The incidence of post-operative AF among high-risk patients was significantly reduced by a prophylactic amiodarone treatment resulting in a shorter time of intensive care unit and hospital stay.
Type of Study: orginal article |
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References
1. Ji Q, Mei Y, Wang X, Feng J, Wusha D, Cai J, et al. Combination of irbesartan and amiodarone to maintain sinus rhythm in patients with persistent atrial fibrillation after rheumatic valve replacement. Circ J 2010;74(9):1873-9. http://dx.doi.org/10.1253/circj.cj-10-0254. [DOI:10.1253/circj.CJ-10-0254] [PMID]
2. Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation: the Framingham study: The Framingham study. N Engl J Med 1982;306(17):1018-22. http://dx.doi.org/10.1056/NEJM198204293061703 [DOI:10.1056/NEJM198204293061703] [PMID]
3. Krahn AD, Manfreda J, Tate RB, Mathewson FA, Cuddy TE. The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. Am J Med 1995;98(5):476-84. http://dx.doi.org/10.1016/S0002-9343(99)80348-9. [DOI:10.1016/S0002-9343(99)80348-9] [PMID]
4. Ji Q, Mei Y, Wang X, Sun Y, Feng J, Cai J, et al. Effect of preoperative atorvastatin therapy on atrial fibrillation following off-pump coronary artery bypass grafting. Circ J 2009;73(12):2244-9. http://dx.doi.org/10.1253/circj.cj-09-0352. [DOI:10.1253/circj.CJ-09-0352] [PMID]
5. von Oppell UO, Masani N, O'Callaghan P, Wheeler R, Dimitrakakis G, Schiffelers S. Mitral valve surgery plus concomitant atrial fibrillation ablation is superior to mitral valve surgery alone with an intensive rhythm control strategy. Eur J Cardiothorac Surg 2009;35(4):641-50. http://dx.doi.org/10.1016/j.ejcts.2008.12.042. [DOI:10.1016/j.ejcts.2008.12.042] [PMID]
6. Sims JB, Roberts WC. Comparison of findings in patients with versus without atrial fibrillation just before isolated mitral valve replacement for rheumatic mitral stenosis (with or without associated mitral regurgitation). Am J Cardiol 2006;97(7):1035-8. http://dx.doi.org/10.1016/j.amjcard.2005.11.023. [DOI:10.1016/j.amjcard.2005.11.023] [PMID]
7. Wang TJ, Larson MG, Levy D, Vasan RS, Leip EP, Wolf PA, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study: The Framingham heart study. Circulation 2003;107(23):2920-5. http://dx.doi.org/10.1161/01.CIR.0000072767.89944.6E [DOI:10.1161/01.CIR.0000072767.89944.6E] [PMID]
8. Friberg L, Hammar N, Edvardsson N, Rosenqvist M. The prognosis of patients with atrial fibrillation is improved when sinus rhythm is restored: report from the Stockholm Cohort of Atrial Fibrillation (SCAF). Heart 2009;95(12):1000-5. http://dx.doi.org/10.1136/hrt.2008.149237 [DOI:10.1136/hrt.2008.149237] [PMID]
9. Suzuki S, Yamashita T, Ohtsuka T, Sagara K, Uejima T, Oikawa Y, et al. Prevalence and prognosis of patients with atrial fibrillation in Japan: a prospective cohort of Shinken Database 2004. Circ J 2008;72(6):914-20. [DOI:10.1253/circj.72.914] [PMID]
10. Creswell LL, Schuessler RB, Rosenbloom M, Cox JL. Hazards of postoperative atrial arrhythmias. Ann Thorac Surg 1993;56(3):539-49. http://dx.doi.org/10.1016/0003-4975(93)90894-n. [DOI:10.1016/0003-4975(93)90894-N] [PMID]
11. Fuller JA, Adams GG, Buxton B. Atrial fibrillation after coronary artery bypass grafting: is it a disorder of the elderly? J Thorac Cardiovasc Surg 1989;97:821-5. [DOI:10.1016/S0022-5223(19)34483-6] [PMID]
12. Frost L, Mølgaard H, Christiansen EH, Hjortholm K, Paulsen PK, Thomsen PEB. Atrial fibrillation and flutter after coronary artery bypass surgery: epidemiology, risk factors and preventive trials. Int J Cardiol 1992;36(3):253-61. http://dx.doi.org/10.1016/0167-5273(92)90293-c. [DOI:10.1016/0167-5273(92)90293-C] [PMID]
13. Mitchell LB, Exner DV, Wyse DG, Connolly CJ, Prystai GD, Bayes AJ, et al. Prophylactic Oral Amiodarone for the Prevention of Arrhythmias that Begin Early After Revascularization, Valve Replacement, or Repair: PAPABEAR: a randomized controlled trial: PAPABEAR: A randomized controlled trial. JAMA 2005;294(24):3093-100. http://dx.doi.org/10.1001/jama.294.24.3093. [DOI:10.1001/jama.294.24.3093] [PMID]
14. Rankin JS, Orozco RE, Addai TR, Rodgers TL, Tuttle RH, Shaw LK, et al. Several new considerations in mitral valve repair. J Heart Valve Dis 2004;13(3):399-409. [Google Scholar]
15. Installe E, Schoevaerdts JC, Gadisseux P, Charles S, Tremouroux J. Intravenous amiodarone in the treatment of various arrhythmias following cardiac operations. J Thorac Cardiovasc Surg 1981;81(2):302-8. [DOI:10.1016/S0022-5223(19)37640-8] [PMID]
16. Singh BN, Vaughan Williams EM. The effect of amiodarone, a new anti-anginal drug, on cardiac muscle. Br J Pharmacol 1970;39(4):657-67. http://dx.doi.org/10.1111/j.1476-5381.1970.tb09891.x. [DOI:10.1111/j.1476-5381.1970.tb09891.x] [PMID] []
17. Guarnieri T, Nolan S, Gottlieb SO, Dudek A, Lowry DR. Intravenous amiodarone for the prevention of atrial fibrillation after open heart surgery: the Amiodarone Reduction in Coronary Heart (ARCH) trial. J Am Coll Cardiol 1999;34(2):343-7. http://dx.doi.org/10.1016/s0735-1097(99)00212-0. [DOI:10.1016/S0735-1097(99)00212-0] [PMID]
18. Brodsky MA, Allen BJ, Walker CJ 3rd, Casey TP, Luckett CR, Henry WL. Amiodarone for maintenance of sinus rhythm after conversion of atrial fibrillation in the setting of a dilated left atrium. Am J Cardiol 1987;60(7):572-5. http://dx.doi.org/10.1016/0002-9149(87)90307-9. [DOI:10.1016/0002-9149(87)90307-9] [PMID]
19. Brodsky MA, Allen BJ, Walker CJ 3rd, Casey TP, Luckett CR, Henry WL. Amiodarone for maintenance of sinus rhythm after conversion of atrial fibrillation in the setting of a dilated left atrium. Am J Cardiol 1987;60(7):572-5. http://dx.doi.org/10.1016/0002-9149(87)90307-9. [DOI:10.1016/0002-9149(87)90307-9] [PMID]
20. Amr YM, Elmistekawy EM, Hammad AAM. Intraoperative loading dose of amiodarone for prophylaxis against atrial fibrillation after valvular heart surgery. Anesth Essays Res 2010;4(2):96-101. http://dx.doi.org/10.4103/0259-1162.73515. [DOI:10.4103/0259-1162.73515] [PMID] []
21. Kar SK, Dasgupta CS, Goswami A. Effect of prophylactic amiodarone in patients with rheumatic valve disease undergoing valve replacement surgery. Ann Card Anaesth 2011;14(3):176-82. http://dx.doi.org/10.4103/0971-9784.83986. [DOI:10.4103/0971-9784.83986] [PMID]
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