Efficacy of intravenous amiodarone in treatment of arrhythmia after adult cardiac surgery

ABSTRACT

The response of cardiac arrhythmias to amiodarone therapy was studied in 58 cardiac surgery patients with pre or post-operative arrhythmia. Patients were given amiodarone intravenously in a dose of 5 mg/kg body weight followed by 400 mg. orally after 2 hours. The serum amiodarone and its metabolite, desethylamiodarone were monitored every two hours. The time at which reversion to sinus rhythm occurred was recorded in each patient. About 46 percent of patients with postoperative atrial arrhythmia reverted within the first 2 hrs, and 20 percent reverted at 4 hrs, after amiodarone administration. While in patients with preoperative atrial arrhythmias only 18 percent reverted at 2 hrs, and 32 percent at 4 hrs. Cases with ventricular arrhythmias, although few, still show a longer delay in response to the amiodarone treatment. The earlier response of cases with postoperative atrial arrhythmias could be correlated to serum amiodarone level, the more established preoperative arrhythmias conceivably required longer time to respond. Apart from, mild hypertension, nausea, tremors and headache, no life threatening toxic manifestation has occurred with the present amiodarone regimen