ACA App
Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
Home | About us | Editorial Board | Search | Ahead of print | Current Issue | Archives | Submission | Subscribe | Advertise | Contact | Login 
Users online: 774 Small font size Default font size Increase font size Print this article Email this article Bookmark this page
 


 

 
     
    Advanced search
 

 
 
     
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  


    References

 Article Access Statistics
    Viewed1511    
    Printed51    
    Emailed0    
    PDF Downloaded155    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents
LETTER TO EDITOR  
Year : 2012  |  Volume : 15  |  Issue : 3  |  Page : 253-254
Effect of prophylactic amiodarone in a patient with rheumatic valve disease undergoing valve replacement surgery


Department of Cardiac Anesthsiology and Critical Care, Aditya CARE Hospital, Bhubaneswar, Orissa, India

Click here for correspondence address and email

Date of Web Publication4-Jul-2012
 

How to cite this article:
Chowdhry V. Effect of prophylactic amiodarone in a patient with rheumatic valve disease undergoing valve replacement surgery. Ann Card Anaesth 2012;15:253-4

How to cite this URL:
Chowdhry V. Effect of prophylactic amiodarone in a patient with rheumatic valve disease undergoing valve replacement surgery. Ann Card Anaesth [serial online] 2012 [cited 2019 Nov 15];15:253-4. Available from: http://www.annals.in/text.asp?2012/15/3/253/97988


The Editor,

Kar et al.[1] have evaluated the effectiveness of prophylactic single-dose amiodarone in the prevention of atrial fibrillation (AF) in patients undergoing valve surgery. Their efforts are appreciable, as maintenance of sinus rhythm (SR) is always preferable over rate control in cardiac surgical patients [2] for optimizing cardiac output. However, few points need to be addressed. As all the patients were getting beta blockers, calcium channel blockers with or without digoxin in the preoperative period, it would have been more informative if the duration of the treatment and doses of the drugs in both the groups were mentioned. Continuation of these drugs in the postoperative period has an important bearing on the reversion and maintenance of SR. It is important to know whether these drugs were restarted in the postoperative period or not. The preoperative rhythm as well as duration of AF is an important factor for rhythm control, as it is known that it is very difficult for chronic AF (more than 8 weeks duration) [3] to revert back to SR in patients with large left atrium even with electrical cardioversion.

The AF when detected for the first time is classified [4] as first-detected episode of AF, whether or not symptomatic or self-limited, recognizing the uncertainty about the actual duration of the episode and about previous undetected episodes. After two or more episodes, AF is considered recurrent. If the arrhythmia terminates spontaneously, recurrent AF is designated paroxysmal; when sustained beyond 7 days, it is termed persistent. Termination with pharmacological therapy or direct-current cardioversion does not alter the designation. First-detected AF may be either paroxysmal or persistent. The category of persistent AF also includes cases of long-standing AF (longer than 1 year), usually leading to permanent AF, in which cardioversion has failed. The type of AF patients included in the study also needs a mention as it is an important factor for conversion to SR.

The long-term maintenance of SR is of paramount importance in the prevention of AF-related complications. [5] The present study provided data for only 24 h. A future study is probably required to evaluate the longevity of a single-dose amiodarone-induced restoration of SR in valve replacement surgery.

 
   References Top

1.Kar SK, Dasgupta CS, Goswami A. Effect of prophylactic amiodarone in patients with rheumatic valve disease undergoing valve replacement surgery. Ann Card Anaesth 2011;14:176-82.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Vora A, Karnad D, Goyal V, Naik A, Gupta A, Lokhandwala Y, et al . Control of rate versus rhythm in rheumatic atrial fibrillation: a randomized study. Indian Heart J 2004;56:110-6.  Back to cited text no. 2
[PUBMED]    
3.Van Gelder IC, Crijns HJ, Van Gilst WH, Verwer R, Lie KI. Prediction of uneventful cardioversion and maintenance of sinus rhythm from direct-current electrical cardioversion of chronic atrial fibrillation and flutter. Am J Cardiol 1991;68:41-6.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.Fuster V, Ryden LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, et al. ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation: Executive Summary. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology. Circulation. 2001;104:2118-50.  Back to cited text no. 4
    
5.Vaturi M, Sagie A, Shapira Y, Feldman A, Fink N, Strasberg B, et al . Impact of atrial fibrillation on clinical status, atrial size and hemodynamics in patients after mitral valve replacement. J Heart Valve Dis 2001;10:763-6  Back to cited text no. 5
    

Top
Correspondence Address:
Vivek Chowdhry
Department of Cardiac Anesthesiology and Critical Care, Chandrasekharpur, Bhubaneswar, Orissa - 751 014
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.97988

Rights and Permissions




 

Top