Abstract
ObjectiveTo evaluate the efficiency of amiodarone in preventing the occurrence of reperfusion ventricular fibrillation (RVF) after aortic cross-clamp (ACC) release in patients undergoing open-heart surgery.MethodsWe searched the Web of Science, Cochrane Library, EMBASE, and PubMed databases through January 2021 for relevant studies addressing the efficacy of amiodarone in preventing RVF after ACC release in patients undergoing cardiac surgery. A complete statistical analysis was performed using RevMan 5.3. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to express the results of dichotomous outcomes using random or fixed-effect models. The chi-square test and I2 test were used to calculate heterogeneity.ResultsSeven studies (856 enrolled patients; 311 in the amiodarone group, 268 in the lidocaine group, and 277 in the placebo group) were selected for the meta-analysis. The incidence of RVF was significantly decreased in the amiodarone group compared to the placebo group (RR = 0.69, 95%CI: 0.50–0.94, P = 0.02). However, amiodarone and lidocaine did not confer any significant difference (RR = 0.98, 95%CI: 0.61–1.59, P = 0.94). The percentage of patients requiring electric defibrillation counter shocks (DCSs) did not confer any significant difference between patients administered amiodarone and lidocaine or placebo (RR = 1.58, 95%CI: 0.29–8.74, P = 0.60; RR = 0.55, 95%CI: 0.27–1.10, P = 0.09; respectively).ConclusionsAmiodarone is more effective than a placebo in preventing RVF after ACC release in cardiac surgery. However, the amiodarone group required the same number of electrical DCSs to terminate RVF as the lidocaine or placebo groups.
Highlights
Open-heart surgery is a primary treatment option for patients with severe valvular heart disease (VHD) and multiplevessel coronary heart disease (CHD) (1–3)
Our search criteria included: (1) randomized controlled trials (RCTs), (2) all enrolled adult patients who required aortic cross-clamp (ACC) after undergoing open-heart surgery, (3) patients were randomly divided into the placebo group, lidocaine group, or amiodarone group, and (4) primary outcome measurements were included with the incidence of reperfusion ventricular fibrillation (RVF), and percentage of patients requiring electric defibrillation counter shocks (DCSs)
A total of 856 participants were enrolled in the 7 RCTs (5, 7, 9–11, 14, 15); 311 patients were included in the amiodarone group, 268 in the lidocaine group and 277 in the placebo group
Summary
Open-heart surgery is a primary treatment option for patients with severe valvular heart disease (VHD) and multiplevessel coronary heart disease (CHD) (1–3). Ventricular fibrillation (VF) frequently occurs after aortic cross-clamp (ACC) release in patients undergoing open-heart surgery (5–7), which can result in reperfusion ventricular fibrillation (RVF) when myocardium reperfusion is initiated. This surgical consequence is associated with a negative impact on morbidity and mortality (5–7). Earlier studies have reported that the incidence of RVF occurrence after ACC release ranges between 45 and 100% (9–11), but a more recent study reported that the rate is between 10 and 80% (7) This variation in RVF incidence indicates a change in the type of cardiac operation and the experience and skills of the surgeon (6)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
