Amiodarone vs digoxin in the treatment of atrial fibrillation in postoperative rheumatic cardiac valvular patients. | [Journal of Pakistan Medical Association • 2016]

Author(s):

1. Sharjeel Abbas: Department of Anatomy, LUMHS, Jamshoro, Pakistan

2. Waseem Riaz: Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, Pakistan

3. Junaid Fayyaz Khan: Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, Pakistan

4. Sharif Nassery: Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, Pakistan

5. Madiha Iqbal: CME, Department, Punjab Institute of Cardiology, Lahore, Pakistan

6. Abdul-Waheed : Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, Pakistan

Abstract:

Objective: To compare the efficacy of amiodarone and digoxin for patients who underwent valve-related cardiac surgery and had atrial fibrillation in the first 72 hours post-operatively. Methods: The observational/descriptive study was conducted at the Punjab Institute of Cardiology, Lahore, Pakistan, from January to December 2011. Patients with associated cardiac problems were excluded. Those selected were followed up for 3 days in intensive care unit after undergoing operation on cardiac valves. They were divided into three groups: those who had new onset atrial fibrillation, chronic atrial fibrillation or no atrial fibrillation. The diagnosis was established on the basis of electrocardiogram. The surgeon, the attending doctor in intensive care and the patient were all unaware of the study. The decision to use either digoxin or amiodarone was left to the duty doctor in intensive care unit. The first two groups were furthersubdivided into Group A that had those who received amiodarone while Group B patients received digoxin. SPSS 19 was used for data analysis. Results: Out of the 176 patients operated, 93(52.9%) had atrial fibrillation post-operatively. Of them, 65(69.9%) were men and 28 were women. Group A had 29(31.2%) patients and Group B had 64(68.9%). Overall, 49(52.7%) patients developed new onset atrial fibrillation, while 44(47.3%) had chronic atrial fibrillation when received in the intensive care unit. Atrial fibrillation was not reverted in 12(41.4%) patients from Group A and 32(50%) from Group B, whereas no symptom improvement was found in 2(6.9%)patients of Group A and 7(10.9%)of Group B. The two groups had the same effect in the treatment of atrial fibrillation in post-operative patients for cardiac rheumatic valve disease (P-value=0.441). Conclusion: Amiodarone was found to be as effective as digoxin in reverting atrial fibrillation and improving symptoms and none of the two drugs had greater benefit than the other.

Page(s): 1098-1101

DOI: DOI not available

Published: Journal: Journal of Pakistan Medical Association, Volume: 66, Issue: 9, Year: 2016

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