ABSTRACT

Aim: To examine the role of amiodarone for prevention of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting.

Study design: Prospective study

Place and duration of study: Department of Cardiothoracic Surgery, Shaikh Zayed Hospital, Lahore from 1st April 2019 to 31st August 2020.

Methodology: One hundred and twenty patients of both genders were included. Patient’s ages were ranging from 30 to 80 years. They were divided into two groups, 60 patients of group A (amiodarone) and 60 in group B (control). Patient’s detailed medical history was examined after taking informed consent from all the patients. In group A, all the patients received amiodarone dose of 10 mg/kg/d for 48 hours postoperatively. After surgery, 600 mg/d of amiodarone oral dose was given for next 5 days. 400mg/g to next 5 days and then started 200 mg/d for 20 days. In Group B, 60 patients received placebo.

Results: In Group A, 49(81.67%) patients were males while 11(18.33%) patients were females with mean age 56.7±9.6 years. In Group B, 45 (75%) patients were males while 25% patients were females with mean age 58.4±7.5 years. Post-operative atrial fibrillation found in 7(11.67%) patients in group A while in placebo group, 26 (1830%) patients found to had atrial fibrillation (p-value 0.015). In group A, atrial fibrillation duration was 11.7±5.8 hrs and in Group B, it was 35.8±26.6 hrs respectively. The maximum ventricular rate during atrial fibrillation was slower in the amiodarone group than in the control group (103.7±20.3 beats per minute and 128.0±16.5 beats per minute. Group A patients had less hospital stay than that of Group B (p-value 0.016). There was no difference found in term of mortality between two groups (p-value >0.05.

Conclusion: After surgery intravenous amiodarone, followed by oral amiodarone shows better results interms of postoperative atrial fibrillation. Amiodarone group had less hospital stay than control group.

Keyword: Coronary artery bypass surgery, Atrial fibrillation, IV Amiodarone, Oral amiodarone