Role of Prophylactic Use of Amiodarone to Prevent Post-Operative Dysrhythmias in Patients with Low Ejection Fraction (EF ≤35%)

Abstract

ABSTRACT:
 Objective:
 To determine the role of amiodarone prophylaxis in the prevention of dysrhythmias following coronary artery bypass grafting (CABG) in patients with low ejection fraction (EF).
 Methods:
 In this prospective comparative study, we included150 patients who underwent coronary artery bypass grafting (CABG) in Multan Institute of Cardiology within a duration of 07 months from Jan-2019 to Aug-2019 having low ejection fraction (EF ≤35%). In the intervention(amiodarone) group (N=75), 3 mg/Kg of amiodarone was given after removal of X-clamp and before weaning from cardiopulmonary bypass. while in the remaining 75 patients no anti-arrhythmic treatment was given in the peri-operative period. Occurrence of postoperative arrhythmia (AF and bradycardia) during the primary hospital stay after surgery was a primary study endpoint.
 Results:
 There was no significant difference between the mean age, gender and body mass index (BMI) of patients in the two groups. Regarding per-operative data, there was no significant difference in number of grafts in amiodarone group 3.9±0.53 and control group 3.04±0.50 (p-value 0.20). Frequency of Atrial fibrillation (AF) after the surgery was significantly differenced in both groups. In the amiodarone group, 13 (17.3%) patients developed POAF and in the control group, POAF occurred in 25 (33.3%) patients (p-value 0.024).
 Conclusion:
 Amiodarone prophylaxis significantly lower the incidence of POAF after CABG in patients with low EF. Amiodarone is easy to administer and is a valuable adjuvant for prevention of POAF.

Comparing the Effect of Perioperative Amiodarone and Magnesium Sulphate Combination with Magnesium Sulphate for Prevention of Cardiac Dysrhythmias in Open Heart Surgeries: A Quasi-Experimental Study

“…1 Dysrhythmias occur in around 40% to 60% of Coronary Artery Bypass Graft surgeries, which not only increases hospital stay but also affects economic outlays. 2 Among post CABG cardiac dysrhythmias (premature ventricular contractions, premature atrial contraction, conduction blocks, paroxysmal supraventricular tachycardia, ventricular tachycardia and ventricular fibrillation), atrial fibrillation is the most common. 3 Besides beta-blockers, calcium channel blockers, amiodarone, magnesium, sotalol, and digoxin have been in use controlling dysrhythmias, Electrical cardio version has also been very effective and useful in treating critically ill patients.…”