Amiodarone for the prevention of reperfusion ventricular fibrillation.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the efficacy of prophylactic single-dose amiodarone administered through the pump circuit before releasing the aortic cross-clamp (ACC) in preventing the occurrence of reperfusion ventricular fibrillation (RVF).

DESIGN:

A prospective, randomized double-blind, placebo-controlled efficacy study.

SETTING:

A tertiary level teaching hospital.

INTERVENTION:

Seventeen patients received 150 mg of amiodarone in 10 mL of normal saline by way of the pump 3 minutes before releasing the ACC, and a control group of 17 patients received 10 mL of normal saline.

MEASUREMENT AND MAIN RESULTS:

The primary outcome of the study was the incidence of ventricular fibrillation requiring defibrillation during the 30-minute period after myocardial reperfusion. A large decrease in RVF (65% to 18%) was observed in the amiodarone-treated group with the number needed to treat only 2.1.The myocardial performance in terms of cardiac output was better in the amiodarone group; this could be attributed to the lower incidence of RVF and subsequent direct current shock therapy.

CONCLUSIONS:

The observations showed that single-dose prophylactic amiodarone administered through the pump circuit 3 minutes before ACC release was an effective therapy to reduce the incidence of post-ACC release ventricular arrhythmias.

• Authors: Aloka Samantaray, Abha Chandra, Sanjukta Panigrahi
• Journal: Journal of cardiothoracic and vascular anesthesia (J Cardiothorac Vasc Anesth) Vol. 24 Issue 2 Pg. 239-43 (Apr 2010) ISSN: 1532-8422 [Electronic] United States
• PMID: 19800815 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright (c) 2010 Elsevier Inc. All rights reserved.

Chemical References

• Amiodarone

Topics

• Adult
• Amiodarone (therapeutic use)
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Myocardial Reperfusion (adverse effects)
• Myocardial Reperfusion Injury (complications, physiopathology, prevention & control)
• Prospective Studies
• Ventricular Fibrillation (complications, physiopathology, prevention & control)