Role of Prophylactic Use of Amiodarone to Prevent Post-Operative Dysrhythmias in Patients with Low Ejection Fraction (EF ≤35%)

ABSTRACT: Objective:           To determine the role of amiodarone prophylaxis in the prevention of dysrhythmias following coronary artery bypass grafting (CABG) in patients with low ejection fraction (EF). Methods:           In this prospective comparative study, we included150 patients who underwent coronary artery bypass grafting (CABG) in Multan Institute of Cardiology within a duration of 07 months from Jan-2019 to Aug-2019 having low ejection fraction (EF ≤35%). In the intervention(amiodarone) group (N=75), 3 mg/Kg of amiodarone was given after removal of X-clamp and before weaning from cardiopulmonary bypass. while in the remaining 75 patients no anti-arrhythmic treatment was given in the peri-operative period. Occurrence of postoperative arrhythmia (AF and bradycardia) during the primary hospital stay after surgery was a primary study endpoint. Results:           There was no significant difference between the mean age, gender and body mass index (BMI) of patients in the two groups. Regarding per-operative data, there was no significant difference in number of grafts in amiodarone group 3.9±0.53 and control group 3.04±0.50 (p-value 0.20). Frequency of Atrial fibrillation (AF) after the surgery was significantly differenced in both groups. In the amiodarone group, 13 (17.3%) patients developed POAF and in the control group, POAF occurred in 25 (33.3%) patients (p-value 0.024). Conclusion:           Amiodarone prophylaxis significantly lower the incidence of POAF after CABG in patients with low EF. Amiodarone is easy to administer and is a valuable adjuvant for prevention of POAF.