EJMS

Abstract

Background: Amiodarone has been proposed to decrease atrial fibrillation and ventricular arrhythmias after valvular surgery. Aim of the work: To evaluate the potentials of amiodarone in prevention of postoperative atrial fibrillation as well as ventricular arrhythmia in patients undergoing valvular heart surgery due aortic stenosis, mitral stenosis or mitral regurgitation. Patients and methods: The study was conducted as a randomized double blind trial of intravenous amiodarone versus placebo. Patients were grouped in 2 groups: AVR group undergoing aortic valve replacement, and MVR group who were undergoing mitral valve replacement. Then both groups were randomized to a control group who received placebo, and an experimental group who received amiodarone. Results: In AVR group, patients who received amiodarone showed statistically significant differences in the following aspects: they were more likely to show spontaneous restoration of sinus rhythm after release of ACC (p < 0.0002), less likely to show ventricular arrhythmias after release of ACC (p < 0.0002), less likely to show ventricular arrhythmias till the end of surgery (p = 0.004), and less likely to need temporary pacemakers (p = 0.003). In MVR group, patients who received amiodarone showed statistically significant differences in the following aspects: they were more likely to show spontaneous restoration of sinus rhythm after release of ACC (p < 0.0002), less likely to show AF after release of ACC (p < 0.0002), less likely to show ventricular arrhythmias after release of ACC (p < 0.0002), and less likely to need temporary pacemakers (p < 0.0002). Conclusion: Amiodarone prophylaxis in cardiac surgery is a safe and effective method to reduce atrial fibrillation and ventricular arrhythmias after valvular surgery.