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العنوان
Comparison of Effects of Amiodarone versus Verapamil in Prevention of Atrial Fibrillation Post Coronary Artery Bypass Grafting \
المؤلف
Mohammed, Arafat Mahmoud.
هيئة الاعداد
باحث / عرفات محمود محمد عبد الرحمن
مشرف / مجدى محمد حسين نافع
مشرف / شــريف جــورج أنيــس
مناقش / مجدى محمد حسين نافع
تاريخ النشر
2019.
عدد الصفحات
129 p. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
العناية المركزة والطب العناية المركزة
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - الرعاية المركزة
الفهرس
Only 14 pages are availabe for public view

from 129

from 129

Abstract

A trial fibrillation (AF) is the most common sustained arrhythmia affecting humans. The initiation of AF may be caused by rapidly firing foci, in the pulmonary vein(s). Although the atrial rate is rapid,the ventricular response depends on atrioventricular (AV) node conduction and the autonomic tone conductivity of AV node.
Although the pathogenesis of AF after open heart surgery is incompletely understood, stimuli &triggers such as pre-existing structural changes of the atria related to hypertension, volume over load, age, atrial ischemia, electrolytes imbalances and pericardial lesions are thought to play a role in the pathogenesis of atrial fibrillation after coronary artery bypass grafting
The aim of the present study was to compare to compare effects of amiodarone and verapamil in prevention of atrial fibrillation post coronary artery bypass graft in patients with dilated left atrium.
The study was carried out on 300 patients after approval of the medical ethical committee of Faculty of Medicine, Ain Shams University and obtaining informed written consent from all studied patients.
We have (300) patients undergoing CABG surgery ware included in the study with dilated left atrium (more than 5mm in diameter).
Divided into three groups, group (A): Included (100) patients, received IV amiodarone in a dose of 300 mg I V loading dose followed by1200 mg /day by infusion. (50 mg/h), group (B) included: (100), patients received IV verapamil in dose of 0.6 mg/kg/h I V by infusion, group (C) included (100) patients as a control group and received placebo in the form of equal volume of normal saline 0.9% infusion.
These medications were given by IV infusion for 48 hours before surgery. We excluded patients with chronic pre-existing AF or atrial flutter, previous cardiac surgery, Patients on pacemaker, Patients on antiarrythmic drugs and Contraindications to any of the medications used in the study.
In our study, the rate effects of amiodarone a prevention of atrial fibrillation post coronary artery bypass is 24%. On the other hand, success rate effects of verapamil in prevention of atrial fibrillation post coronary artery bypass is 38%.
The results of our study showed the superiority of amiodarone (p-value was significant =0.019) in prevention of atrial fibrillation post coronary artery than verapamil (p-value was significant =0.032).
Also The results of our study showed the superiority of amiodarone group (A) (p-value was significant =0.022) in to decrease length of hospital stay significant fewer days than those in the Verapamil group (B) and placebo group (C).