Document Detail


Impact of early and standardized treatment with amiodarone on therapeutic success and outcome in pediatric patients with postoperative tachyarrhythmia.
MedLine Citation:
PMID:  19026806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Effects of timing of inception of amiodarone antiarrhythmic treatment after corrective surgery for congenital heart defects are not yet well defined. METHODS: In a 10-year prospective observational study, 71 of 2651 patients (2885 procedures, 2106 bypass procedures) received amiodarone for newly detected postoperative atrial (n = 70) or ventricular (n = 7) tachyarrhythmia: early treatment (initiation within 60 minutes of arrhythmia detection) and late treatment (after that). From an interim analysis, a treatment protocol was established (32 patients). Inotropic requirements were monitored, as were heart rate, blood pressure, central venous pressure, and sedation requirements. RESULTS: With early treatment (n = 29), delay before start of amiodarone was 40.7 +/- 21.9 minutes, versus 227.7 +/- 228.1 minutes (P < .001) with late treatment (n = 42). There were significant benefits of early treatment for times to rate (155.9 +/- 299.8 vs 407.6 +/- 376.9 minutes, (P < .001) and rhythm control (400.4 +/- 845 vs 1038.5 +/- 1158.4 minutes, P < .001), reduction in dose needed for rate control (28.2 +/- 45.2 vs 66.5 +/- 137.5 mg, P < .025), and significant reduction in pediatric cardiac intensive care unit stay (3.32 +/- 1.9 vs 5.26 +/- 4.27 days, P < .01). There were continuous improvements in heart rate, blood pressure, and filling pressures without additional inotropic requirements or side effects. CONCLUSION: Early treatment of postoperative tachyarrhythmia with amiodarone according to a standardized treatment protocol is safe and has beneficial effects on arrhythmia control and pediatric cardiac intensive care unit stay.
Authors:
Nikolaus A Haas; Christoph K Camphausen
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-06-12
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  136     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2008-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1215-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatric Cardiac Intensive Care, The Prince Charles Hospital, Brisbane, Australia. nikhaas@hdz-nrw.de
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MeSH Terms
Descriptor/Qualifier:
Amiodarone / administration & dosage,  adverse effects,  therapeutic use*
Anti-Arrhythmia Agents / administration & dosage,  adverse effects,  therapeutic use*
Blood Pressure / drug effects
Central Venous Pressure / drug effects
Heart Defects, Congenital / surgery*
Heart Rate / drug effects
Humans
Hypnotics and Sedatives / administration & dosage
Infant
Intensive Care
Postoperative Complications
Prospective Studies
Tachycardia / drug therapy*
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Hypnotics and Sedatives; 1951-25-3/Amiodarone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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