Post-operative Combo prophylaxis for Ventricular tachycardia/Ventricular fibrillation/Torsades de pointes with Intravenous Amiodarone and Magnesium sulphate in Valve surgery patient with minimum one heart chamber dilated: A randomized trial

Mohammed Aslam Hossain, Md. Sanaul H. Sarker

Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Date, time and location: 2018.05.25 10:30, Exhibition area, 1st Floor. Zone – D

Abstract

Background:

Patients undergoing valve surgery (AVR, MVR, DVR) have arrhythmogenic heart. When they come to surgeons they come with moderate to severe form of valvular disease with at least one chamber of heart dilated which maybe LA, RA, LV or RV. Dilated heart chamber works as a focus of arrhythmia like AF, VT, VF, Torsades de pointes or other arrhythmias. This study aimed to evaluate the prophylactic effect of Amiodarone and Magnesium sulfate (MgSO₄) for preventing Post valvular surgery life threatening VT, VF, Torsades de pointes.

Materials and Methods:

This randomized controlled trial study is conducted at Cardiac Surgery Intensive Care Unit (CSICU), BSMMU, Dhaka between August 01, 2016 and July 31, 2017. In Group 1 (Amiodarone+MgSO4), 70 patients received 5mg/Kg Amiodarone and 30 mg/kg MgSO₄ in 50 cc infusion pump and in Group 2 (control group), 70 patients received other antiarrythmics and 30mg/kg MgSO4 in 50 cc infusion pump.

Results:

Between two groups, group 1 patients had significant decrease in arrhythmia and ICU stay, reintubation, morbidity and other intervention compared to group 2 patients. There was a significant difference in the incidence of arrhythmia between two groups (P = 0.001). The length of ICU stay was 3.2 ± 1.1 and 3.95 ± 1.72 days in group 1 and 2 (P = 0.001).

Conclusion:

Amiodarone with Magnesium sulphate significantly decreases the incidence of all type of Post Valve surgery arrhythmia especially VF/VT/Torsades de pointes and hospital length of stay. We strongly recommend all valve patient who had dilated any chamber of heart for routine use of post-operative Amiodarone and Magnesium sulphate.