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

ABSTRACT

The response of cardiac arrhythmias to amidoarone therapy was studies in 58 cardiac surgery patients with pre or post-operative arrhythmia. Patients were given amidoarone intravenously in a dose of5mg/kg do by weight followed by 400mg. orally after2 hours. The serum amidoarone 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% of patients with postoperative atrial arrhythmia reverted within the first 2 hrs, and 20% reverted at4 hrs, after amidoarone administration. While inpatients with postoperative atrial arrhythmias only 18%reverted at 2 hrs, and32% at 4 hrs. cases with ventricular arrhythmias, although few, still show a longer delay in response to the amidoarone treatment. The earlier response of cases with postoperative atrial arrhythmias could be correlated to serum amidoarone level, the more established preoperative arrhythmias conceivable required longer time to respond. Apart from, mild hypotension, nausea, tremors and headache, no lift-threatening toxic manifestation has occurred with the present amidoarone regimen