title: A randomized placebo-controlled trial with amiodarone for persistent atrial fibrillation in rheumatic mitral stenosis after successful balloon mitral valvuloplasty.
abstract: OBJECTIVE
  Atrial fibrillation is the most common sustained arrhythmia in patients with rheumatic heart disease (RHD). This study was conducted to determine the maintenance of sinus rhythm with amiodarone therapy following DC cardioversion (DCCV), early after successful balloon mitral valvuloplasty (BMV).
  
  
  METHODS
  Patients were randomized to amiodarone group and placebo group and their baseline characteristics were recorded. DCCV was done 48h after BMV. After cardioversion, oral amiodarone was started initially 200mg three times a day for 2 weeks, then 200mg twice daily for two weeks followed by 200mg once daily for 12 months. Patients in placebo group received DCCV alone without preloading amiodarone. After DCCV, they were given placebo for 12 months.
  
  
  RESULTS
  The 3 months follow-up period was completed by 77 patients (95%). Of them, 31 (77.5%) patients in amiodarone group and 14 (34.1%) in placebo group remained in sinus rhythm (SR). The 12 months follow-up period was completed by 73 patients (90.1%). Of them, 22 (55%) patients in amiodarone group and 7 (17.1%) in placebo group remained in SR.
  
  
  CONCLUSIONS
  We conclude that amiodarone is more effective than placebo in maintenance of SR at the end of 3 months following successful cardioversion and more patients continued to remain in SR even at the end of 12 months without major serious adverse effects.
authors: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India. Electronic address: drvinohere3@gmail.com.
authors: Vinoth Kumar
authors: VK
authors: Vilvanathan
authors: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
authors: Budunur C
authors: BC
authors: Srinivas Prabhavathi Bhat
authors: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
authors: Manjunath Cholenahally
authors: MC
authors: Nanjappa
authors: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
authors: Bharathi
authors: B
authors: Pandian
authors: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
authors: Vithal
authors: V
authors: Bagi
authors: Senior Consultant, Interventional Cardiologist, Sunshine Heart Institute, Hyderabad, India.
authors: Sridhar
authors: S
authors: Kasturi
authors: Researcher, Sunshine Heart Institute, Hyderabad, India.
authors: Shiva Kumar
authors: SK
authors: Bandimida
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000638:Amiodarone / Q000008:administration & dosage*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D063126:Balloon Valvuloplasty / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone
keywords: Anticoagulant; Atrial fibrillation; Mitral stenosis; Rheumatic heart disease