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Indian Journal of Clinical Anaesthesia


Effect of electrocautery maze procedure and amiodarone in rheumatic valvular heart disease patients with atrial fibrillation undergoing mitral valve replacement surgery


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Author Details: Ketaki Ramteke, Yogesh Zanwar, Amol Thakare, Gagan Agrawal, Vijay Shrotey

Volume : 4

Issue : 4

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 530

Article End Page : 535


Abstract

 Introduction: Electrocautery maze and amiodarone will ensure a better controlled sinus rhythm throughout the immediate postoperative period and will make it smoother.
Objective: To study the effect of electrocautery maze procedure and amiodarone in RHD patients with AF undergoing mitral valve replacement surgery.
Materials and Methods: This randomized prospective double blind clinical trial was carried out among 40 patients undergoing mitral valve replacement surgery in a tertiary care hospital. Randomization was done by using lottery method. Patients were randomly assigned in one of the following two groups.
Group I: (CM, n = 20) Cautery maze procedure was done and 100ml normal saline infused over 20 min before induction.
Group II: (CM + A, n = 20) Cautery maze procedure was done & Amiodarone 3 mg/kg body weight diluted in 100 ml normal saline infused over 20 minutes before induction.
Results: In present study 75% patients in group I and 85% patients in group II were in sinus rhythm at ACC release. 10% patients in group I while 5% patient had ventricular tachycardia/fibrillation at ACC release. 1 patient in group I and no patient in group II had recurrence of AF within 3 days postoperatively. There was no statistically significant difference in the mean value of extubation time 9.95±1.31 in group I & 10.80±4.61 in group II & even in ICU stay 4.75±1.74 days in group I, 5.15±1.13 days in group II.
Conclusion: The combination of both electrocautery maze procedure and amiodarone may have a better control over atrial fibrillation than only electrocautery maze procedure alone.

Keywords: Atrial fibrillation, Electrocautery, Amiodarone