| Impact of early and standardized treatment with amiodarone on therapeutic success and outcome in pediatric patients with postoperative tachyarrhythmia. | |
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MedLine Citation:
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PMID: 19026806 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Nikolaus A Haas; Christoph K Camphausen |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-06-12 |
Journal Detail:
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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:
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Created Date: 2008-11-25 Completed Date: 2008-12-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1215-22 Citation Subset: AIM; IM |
Affiliation:
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Department of Paediatric Cardiac Intensive Care, The Prince Charles Hospital, Brisbane, Australia. nikhaas@hdz-nrw.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amiodarone
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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:
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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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