Title:Comparison of Amiodarone Loading Dosage in the Treatment of Postoperative Atrial Fibrillation: High Versus Standard Dose Treatment
Volume: 22
Issue: 6
Author(s): Ersin Sarıçam, Arslan Öcal, Murat Doğan Iscanlı, Engin Bozkurt, Erdogan Ilkay and Ömer Faruk Cantekin*
Affiliation:
- Department of Social Work, Faculty of Health Sciences, Gazi University, Ankara, Turkey
Keywords:
Amiodarone, dosage, postoperative atrial fibrillation, sinus rhythm, laboratory, echocardiographic.
Abstract:
Background: Postoperative atrial fibrillation (POAF) is associated with poor outcomes,
including hemodynamic instability, stroke, myocardial infarction, and death. In hemodynamic stable
patients, the rhythm-control strategy is more advantageous than rate control. Current standard intravenous
amiodarone administration has limited success and a delayed effect; the acute success rate is
44% (8-12 h to several days).
Purpose: The aim of this study was to evaluate the effectiveness of higher amiodarone loading dosage
to restore sinus rhythm in patients with POAF after noncardiac surgery.
Methods: This is a prospective, randomized, controlled single-center study. The study included 39
patients with POAF, divided into group I (n=27) (intravenous 600 mg amiodarone loading dosage
over 2 h and infusion of 50 mg/h over a 24-h period) and group II (n=12) (standard protocol; 300 mg
of bolus intravenously in 30 min and infusion of 50 mg/h over a 24-h period). The primary endpoint
of the study was a restoration of sinus rhythm at the 24th hour.
Results: Baseline clinical, laboratory and echocardiographic characteristics of both groups were similar.
The patients with higher loading amiodarone dosage had earlier restoration of sinus rhythm (2.38
± 1.41 vs 8.66 ± 2.87 h, respectively; p=0.015). There was no significant difference in achieving sinus
rhythm at the 24th hour between both groups.
Conclusion: Higher loading amiodarone dosage increased early conversions to sinus rhythm compared
with standard amiodarone protocol in patients with POAF.
