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ORIGINAL ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 2  |  Page : 189-193

Effect of prophylaxis of amiodarone and magnesium to prevent atrial fibrillation in patients with rheumatic valve disease undergoing mitral valve replacement surgery


1 Department of Cardiothoracic Anaesthesia, GMC, SSH, Jammu; Department of Anaesthesia, GMC, Doda, Jammu and Kashmir, India
2 Department of Cardiothoracic Anaesthesia, GMC, SSH, Jammu; Department of Anaesthesia, GMC, Kathua, Jammu and Kashmir, India

Correspondence Address:
Dr. Rajesh Angral
Plot No. 176, Housing Colony, Janipur, Jammu, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aer.AER_63_20

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Context: Maintenance of sinus rhythm is superior to the incidence of atrial fibrillation (AF) in patients with rheumatic valve disease undergoing mitral valve replacement (MVR) surgery. Aim: To evaluate the effect of prophylactic combination of intravenous (i.v.) amiodarone and magnesium sulfate (MgSO4) in patients undergoing MVR surgery. Materials and Methods: One hundred and twenty patients with valvular heart disease with or without AF were randomly divided into two groups. Group I (n = 60) received amiodarone (3 mg.kg−1 in 20 mL saline) + MgSO4 (30 mg.kg− 1 in 20 mL saline), and Group II (n = 60) received 40 mL of normal saline. The standardized protocol for cardiopulmonary bypass was maintained for all the patients. Statistical Analysis: Continuous variables were expressed as mean ± standard deviation and categorical variables were summarized as frequencies and percentages. Student's independent t-test was employed for comparing continuous variables. Chi-square test was applied for comparing categorical variables. Results: Before surgery, AF was observed in 58.3% of patients in Group I and in 53.3% of patients in Group II (P = 0.581). Postoperatively, in the intensive care unit, 26.7% of the patients in Group I and 71.7% in Group II had AF (P < 0.001). At the time of discharge, 30% of patients in Group I and 73.3% of patients in Group II had AF (P < 0.001). Conclusion: A single combined prophylactic intraoperative dose of i.v. amiodarone and MgSO4 decreased postbypass arrhythmia in comparison to the placebo group in patients of MVR surgery.


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