ROLE OF PRE-INCISION, INTRAVENOUS PROPHYLACTIC AMIODARONE TO CONTROL ARRHYTHMIAS IN PATIENTS WITH RHEUMATIC VALVULAR HEART DISEASE UNDERGOING MITRAL VALVE REPLACEMENT

Abstract

Objective: To evaluate the effect of intra- operative single intra venous dose of amiodarone on post operative cardiac arrhythmias in patients undergoing valvular heart surgery.
Study Design: Randomized controlled trials.
Place and Duration of surgery: This study was performed at Armed forces Institute of Cardiology Rawalpindi form Jan 01, 2011 to Dec 31, 2011.
Patients and Methods: In this study 80 patients with rheumatic valvular heart disease and undergoing elective mitral valve replacement were randomly divided into two groups. Group I, n =40 (Amiodarone group) was given single intravenous dose of amiodarone (5 mg/kg in 100 ml of saline over 30 min) before sternotomy incision. Group II, n=40(control/placebo group) was given 100 ml of saline over 30 min.
Result: In the amiodarone group, after removal of aortic cross clamp 75% patients had sinus rhythm compared to 47.5% in control group. p=0.045. Similarly 15% had AF, 5% JR and 5% VT/VF in amiodarone group in contrast to 32.5% with AF, 12.5% JR and 7.5% Vt/VF in control group. (p=0.045). Response to cardioversion was positive in 75% of the patients requiring shocks in amiodarone group as against 43.75% in the control group. (p=0.044).
Conclusion: A single intravenous bolus dose of amiodarone is effective in decreasing the incidence of cardiac arrhythmias after mitral valve replacement in patients with rheumatic MVD.