Amiodarone for the prevention of reperfusion ventricular fibrillation.
OBJECTIVE
The purpose of this study was to evaluate the efficacy of prophylactic single-dose amiodarone administered through the pump circuit before releasing the aortic cross-clamp (ACC) in preventing the occurrence of reperfusion ventricular fibrillation (RVF).


METHODS
A prospective, randomized double-blind, placebo-controlled efficacy study.


METHODS
A tertiary level teaching hospital.


METHODS
Seventeen patients received 150 mg of amiodarone in 10 mL of normal saline by way of the pump 3 minutes before releasing the ACC, and a control group of 17 patients received 10 mL of normal saline.


RESULTS
The primary outcome of the study was the incidence of ventricular fibrillation requiring defibrillation during the 30-minute period after myocardial reperfusion. A large decrease in RVF (65% to 18%) was observed in the amiodarone-treated group with the number needed to treat only 2.1.The myocardial performance in terms of cardiac output was better in the amiodarone group; this could be attributed to the lower incidence of RVF and subsequent direct current shock therapy.


CONCLUSIONS
The observations showed that single-dose prophylactic amiodarone administered through the pump circuit 3 minutes before ACC release was an effective therapy to reduce the incidence of post-ACC release ventricular arrhythmias.
Department of Anesthesiology and Critical Care, Sri Venkateswara Institute of Medical Sciences, Andhra Pradesh, India. alokorissa@gmail.com
Aloka
A
Samantaray
Abha
A
Chandra
Sanjukta
S
Panigrahi
D000328:Adult; D000638:Amiodarone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion / Q000009:adverse effects*; D015428:Myocardial Reperfusion Injury / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D014693:Ventricular Fibrillation / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*
D000638:Amiodarone