Abstract
Objectives:To explore the efficacy of amiodarone in the treatment of atrial fibrillation for patients with rheumatic heart disease after valve replacement.Methods:Eighty-six patients with rheumatic heart disease who were hospitalized between June 2016 and June 2017 and developed atrial fibrillation after valvular heart valve replacement were randomly divided into a control group and an observation group, 42 cases in each group. The control group was treated with routine medical treatment, while the observation group was given amiodarone on the basis of routine treatment. The cardiac function of the two groups were observed and recorded. Postoperative atrial fibrillation conversion rate, sinus rhythm maintenance rate, intensive care unit (ICU) monitoring time and hospital stay were compared between the two groups.Results:Compared with the control group, the improvement of cardiac function indexes of the observation group was better, and the difference was statistically significant (P<0.05). The atrial fibrillation conversion rate and the maintenance rate of sinus rhythm of the observation group were 76.2% and 47.6% respectively, which were significantly higher than 57.1% and 33.3% of the control group; the differences had statistical significance (P<0.05). The ICU monitoring time and hospitalization time of the patients in the observation group were (1.69±0.91) d and (10.24±1.11) d respectively, which were significantly shorter than (2.83±0.95) d and (14.07±1.17) d in the control group (P<0.05); the differences were statistically significant (P<0.05).Conclusion:Amiodarone can effectively treat valve replacement associated atrial fibrillation of patients with rheumatic heart disease. It can significantly improve the heart function, prevent the recurrence of atrial fibrillation, maintain sinus rhythm after operation, and shorten the time of ICU monitoring and hospitalization.
Highlights
Atrial fibrillation is the most common persistent arrhythmia in clinical practice.[1,2] The incidence of atrial fibrillation after valve replacement is as high as 65% among patients with rheumatic heart disease
This study investigated the effect of amiodarone on atrial fibrillation of patients with valvular replacement associated rheumatic heart disease, aiming to provide a reference for the treatment of valve replacement associated atrial fibrillation
Studies found that improving the conversion rate of atrial fibrillation and maintaining sinus rhythm was the key after rheumatic heart disease associated valve replacement.[12,13]
Summary
Atrial fibrillation is the most common persistent arrhythmia in clinical practice.[1,2] The incidence of atrial fibrillation after valve replacement is as high as 65% among patients with rheumatic heart disease. Pak J Med Sci July - August 2019 Vol 35 No 4 www.pjms.org.pk 918 conversion, which may have adverse effects on patients, cause hemodynamic disorders and even cardiogenic shock, and increase risks of stroke, heart failure and hospitalization mortality.[4,5] how to maintain sinus rhythm effectively after valve replacement, prevent recurrence of atrial fibrillation, avoid complications such as stroke and heart failure, and effectively improve the quality of life of patients have become important problems in cardio-thoracic surgery. Amiodarone has been widely used in the conversion of atrial fibrillation, and its conversion efficiency is as high as 55%.8 This study investigated the effect of amiodarone on atrial fibrillation of patients with valvular replacement associated rheumatic heart disease, aiming to provide a reference for the treatment of valve replacement associated atrial fibrillation
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