Effectiveness Of Amiodarone Research Articles

Effectiveness of antazoline versus amiodarone, flecainide and propafenone in restoring sinus rhythm at the emergency department

PurposeLittle is known about the effectiveness of pharmacological cardioversion (PCV) with antazoline in comparison to flecainide. The aim of this study was to compare the effectiveness of antazoline in restoring sinus rhythm (SR) versus amiodarone, flecainide and propafenone in a group of emergency department (ED) patients. Materials/methodsThis was a single-centre retrospective analysis of patient records from an ED in a large hospital in Poland. We analysed a total of 1878 patient records, divided based on the anti-arrhythmic drug (AAD) administered during PCV: antazoline (n ​= ​1080), antazoline ​+ ​β-blocker (n ​= ​479), amiodarone (n ​= ​129), flecainide (n ​= ​102), propafenone (n ​= ​88). Of the patients, 63.5 ​% were female (median 65 years, [19–100]). ResultsThe percentage of successful PCV was significantly higher in the antazoline group (84.3 ​%) than in the antazoline ​+ ​β-blocker (75.8 ​%, p ​= ​0.0001), propafenone (75.6 ​%, p ​= ​0.0364) and amiodarone (68.8 ​%, p ​< ​0.0001) groups. Post-hoc analysis revealed that patients who received PCV with antazoline, antazoline ​+ ​β-blocker, flecainide and propafenone had significantly shorter time to SR than those who received amiodarone (p ​< ​0.0001). Univariate regression analysis revealed that patients who underwent PCV with antazoline were almost twice as likely to return to SR compared to the other groups (p ​< ​0.0001, OR 1.81, 95 ​% CI 1.44–2.27). ConclusionsThis is the first study comparing the effectiveness of antazoline in PCV versus flecainide in addition to the previously studied amiodarone and propafenone. Our results indicate that antazoline is more effective in restoring SR than amiodarone, flecainide and propafenone. In addition, antazoline restored SR significantly faster than amiodarone or propafenone.

Navigating the Incidence of Postoperative Arrhythmia and Hospitalization Length: The Role of Amiodarone and Other Antiarrhythmics in Prophylaxis.

Antiarrhythmic drugs play a pivotal role in managing and preventing arrhythmias. Amiodarone, classified as a class III antiarrhythmic, has been used prophylactically to effectively prevent atrial fibrillation postoperatively in cardiac surgeries. However, there is a lack of consensus on the use of amiodarone and other antiarrhythmic drugs as prophylaxis to reduce the occurrence of all types of postoperative arrhythmias in cardiac and non-cardiac surgeries. A comprehensive PubMed query yielded 614 relevant papers, of which 52 clinical trials were analyzed. The data collection included the class of antiarrhythmics, timing or method of drug administration, surgery type, type of arrhythmia and its incidence, and hospitalization length. Statistical analyses focused on prophylactic antiarrhythmics and their respective reductions in postoperative arrhythmias and hospitalization length. Prophylactic amiodarone alone compared to placebo demonstrated a significant reduction in postoperative arrhythmia incidence in cardiac and non-cardiac surgeries (24.01%, p<0.0001), and it was the only treatment group to significantly reduce hospitalization length versus placebo (p = 0.0441). Prophylactic use of class 4 antiarrhythmics versus placebo also demonstrated a significant reduction in postoperative arrhythmia incidence (28.01%, p<0.0001), and while there was no significant statistical reduction compared to amiodarone (4%, p=0.9941), a lack of abundant data provides a case for further research on the prophylactic use of class 4 antiarrhythmics for this indication. Amiodarone prophylaxis remains a prime cornerstone of therapy in reducing postoperative arrhythmia incidence and hospitalization length. Emerging data suggests a need for a broader exploration of alternative antiarrhythmic agents and combination therapies, particularly class 4 antiarrhythmics, in both cardiac and non-cardiac surgeries. This meta-analysis depicts the effectiveness of amiodarone, among other antiarrhythmics, in postoperative arrhythmia incidence and hospitalization length reduction in cardiac and non-cardiac surgeries.

Abstract 396: A Novel Machine Learning Approach for Identifying Subgroups With Differential Responses to Amiodarone in Patients With Cardiac Arrest With Shockable Rhythm

Introduction: Although there is a possibility that the effectiveness of amiodarone may differ among a particular subgroup, there are few studies on the differential effects of amiodarone for the out-of-hospital cardiac arrest (OHCA) patients with a shockable rhythm. Objective: To identify subgroups with differential responses to amiodarone in OHCA with shockable rhythm by a novel machine learning approach. Methods: We used data from the Japanese nationwide OHCA registry of the Japanese Association for Acute Medicine. The OHCA patients who had initial shockable rhythm upon hospital arrival were included. The primary outcome was a good neurological outcome at 30 days, defined as a Cerebral Performance Categories score ≤2. We developed a linear score by outcome weighting learning (OWL) method with logistic loss to identify subgroups with differential effects of amiodarone. The difference in the effect of amiodarone between subgroups based on the developed score was evaluated by repeated cross-validation (RCV), and hypothesis testing was performed by the permutation method. Results: Among 68,111 OHCA patients in the registry, data of 2333 patients with initial shockable rhythm upon hospital arrival were analyzed. Our developed score showed that the longer duration from call to EMS to hospital arrival, hypothermia at hospital arrival, and no defibrillation until hospital arrival were important variables that had a trend of increasing the beneficial effect of amiodarone (Table). The effect of amiodarone on neurological outcomes varied significantly among the subgroups identified by the developed scores (OR: 1.05 (95%CI: 0.99-1.13), P [RCV] = 0.038). Conclusions: We successfully developed a model that discriminates between the patients for whom amiodarone had a harmful effect on their neurological outcome from those for whom amiodarone had a beneficial effect. In the patients for whom amiodarone had a harmful effect, the other treatment approaches may be needed.

Effectiveness of Amiodarone, Propafenone And Synchronized Electrical Cardioversion for Conversion of Atrial Fibrillation Paroxysm to Sinus Rhythm in Rigas Stradins University Hospital Department of Emergency Medicine

Introduction: Atrial fibrillation remains one of the major causes of stroke, heart failure, sudden death, and cardiovascular morbidity in the world. Its incidence increases with age and the presence of structural heart disease. Materials and methods: The retrospective analysis was performed on 127 patients over a period of three years (73 men, median age 62, range 37-75, and 54 women, median age 60, range 42-78) duration of atrial fibrillation 48 hours or less. Results: Efficiency of amiodarone i/v converting atrial fibrillation to sinus rhythm detected in 56 of 69 patients (81.2%). Efficiency of propafenone i/v converting atrial fibrillation to sinus rhythm detected in 26 of 33 patients (78.8%). Efficiency of electrical cardioversion was pronounced in 24 of 25 patients (96.0%). (p&lt;0.001 compared to both amiodarone and propafenone). In case if atrial fibrillation duration is less than 8h propafenone is more effective and for atrial fibrillation with duration over 24h more effective is amiodarone. Efficacy of amiodarone and propafenone in converting atrial fibrillation paroxysm to sinus rhythm was almost the same. The effect of amiodarone was slightly superior that of propafenon. Conclusion: Amiodarone, propafenone, and electrical cardioversion all three options provide physicians with effective tools to restore sinus rhythm in patients with atrial fibrillation. Atrial fibrillation duration should be taken into account more often to choose an appropriate treatment in emergency department.

Effectiveness of amiodarone, propafenone and synchronized electrical cardioversion for conversion of atrial fibrillation paroxysm to sinus rhythm in Rigas Stradins University Hospital department of emergency medicine.

Effectiveness of amiodarone, propafenone and synchronized electrical cardioversion for conversion of atrial fibrillation paroxysm to sinus rhythm in Rigas Stradins University Hospital department of emergency medicine.

Comparative Effectiveness of Amiodarone and Lidocaine for the Treatment of In-Hospital Cardiac Arrest

American Heart Association Advanced Cardiac Life Support (ACLS) guidelines support the use of either amiodarone or lidocaine for cardiac arrest caused by ventricular tachycardia or ventricular fibrillation (VT/VF) based on studies of out-of-hospital cardiac arrest. Studies comparing amiodarone and lidocaine in adult populations with in-hospital VT/VF arrest are lacking. Does treatment with amiodarone vslidocaine therapy have differential associations with outcomes among adult patients with in-hospital cardiac arrest from VT/VF? This retrospective cohort study of adult patients receiving amiodarone or lidocaine for VT/VF in-hospital cardiac arrest refractory to CPR and defibrillation between January 1, 2000, and December 31, 2014, was conducted within American Heart Association Get With the Guidelines-Resuscitation participating hospitals. The primary outcome was return of spontaneous circulation (ROSC). Secondary outcomes were 24h survival, survival to hospital discharge, and favorable neurologic outcome. Among 14,630 patients with in-hospital VT/VF arrest, 68.7%(n= 10,058) were treated with amiodarone and 31.3%(n= 4,572) with lidocaine. When all covariates were statistically controlled, compared with amiodarone, lidocaine was associated with statistically significantly higher odds of the following: (1) ROSC (adjusted OR [aOR], 1.15, P= .01; average marginal effect [AME], 2.3; 95%CI, .5-4.2); (2) 24h survival (aOR, 1.16; P= .004; AME, 3.0; 95%CI, 0.9-5.1); (3) survival to discharge (aOR, 1.19; P< .001; AME, 3.3; 95%CI, 1.5-5.2); and (4) favorable neurologic outcome at hospital discharge (aOR, 1.18; P< .001; AME, 3.1; 95%CI, 1.3-4.9). Results using propensity score methods were similar to those from multivariable logistic regression analyses. Compared with amiodarone, lidocaine therapy among adult patients with in-hospital cardiac arrest from VT/VF was associated with statistically significantly higher rates of ROSC, 24h survival, survival to hospital discharge, and favorable neurologic outcome.

An Integrative Comparative Study Between Digoxin and Amiodarone as an Emergency Treatment for Patients With Atrial Fibrillation With Evidence of Heart Failure: A Systematic Review and Meta-Analysis.

The emergency treatment of atrial fibrillation (AF) involves utilizing two strategies. The first strategy normally involves permitting the atrial fibrillation to persevere as the ventricular rate is controlled. The other method involves utilizing anti-arrhythmic drugs in cardioversion and attempting to maintain sinus rhythm. Different pharmacological treatments, including digoxin and amiodarone, have been used to manage AF. A literature review on amiodarone and digoxin in the treatment of AF among patients with heart failure (HF) has shown that both drugs have potential risks. Therefore, we are conducting this systematic review and meta-analysis to compare the effectiveness of amiodarone and digoxin in the treatment of AF among patients with evidence of HF.A literature search of relevant articles was conducted on six electronic databases (PubMed, Web of Science, Medline, ScienceDirect, Cochrane Library, and Google Scholar) from 2000 to 2022. The search yielded seven studies that had met the inclusion criteria. Our meta-analysis of four studies showed that there was no significant difference in the reduction of heart rate after treatment with either amiodarone or digoxin (mean difference (MD): -5.44; 95% confidence interval (CI): -9.53 to -1.34; I2 = 25%; p = 0.26). On the other hand, the statistical analysis showed that amiodarone had a better effect on the conversion to sinus rhythm than digoxin (63% versus 35%, respectively).Based on evidence from our meta-analysis, the clinical effect of amiodarone and digoxin in the emergency treatment of AF on heart rate control was unclear. However, amiodarone has a significant impact on the restoration of sinus rhythm compared with digoxin and can be considered the first-line drug regimen in conversion to sinus rhythm for AF patients with evidence of heart failure. However, the use of amiodarone and digoxin is complicated by adverse events and all-cause mortality.

Effectiveness of amiodarone versus digitalis for heart rate control in critically ill patients with new-onset atrial fibrillation

New-onset of atrial fibrillation (NOAF) in critically ill patients is the most common acute cardiac dysrhythmia, but evidence-based data regarding treatment strategies are scarce. In this retrospective monocentric study, we compared effectiveness of amiodarone versus digitalis for heart rate control in critically ill patients with new-onset of atrial fibrillation. We identified a total of 209 patients for the main analysis. Amiodarone as compared to digitalis was associated with a clinically relevant faster time to heart rate control < 110 bpm (2 h (IQR: 1 h to 6 h) versus 4 h (2 h to 12 h); p = 0.003) and longer durations of sinus rhythm during the first 24 h of treatment (6 h (IQR: 6 h to 22 h) versus 0 h (IQR: 0 h to 16 h); p < 0.001). However, more bradycardic episodes occurred in association with amiodarone than with digitalis (7.7% versus 3.4%; p = 0.019). Use of amiodarone was associated with an increase of noradrenalin infusion rate compared to digitalis (23.9% versus 12.0%; p = 0.019). Within the tertile of patients with the highest CRP measurements, amiodarone treated patients presented with a higher decrease in heart rate than digoxin treated patients. Clinical trials comparing different NOAF treatment strategies are much needed and should report on concomitant sympathetic activity and inflammatory status.

Value of Atrial Fibrillation Prophylaxis after Coronary Artery Bypass Graft Surgery

Background: Heart surgery patients who develop acute and new-onset AF (postoperative atrial fibrillation, POAF) are among the most common postoperative complications, affecting around 35 percent of those who undergo the procedure. Objective: To assess the effectiveness of amiodarone in prophylaxis of AF post coronary artery bypass surgery (CABG). Patients and Methods: Our work represents a randomized clinical trial, which was carried out at National Heart Institute and Zagazig University from the period of August 2020 to June 2021. 68 patients, admitted for CABG and had high risk score according to POAF score, were included in our study. Results: Regarding mean left ventricular ejection fraction (LVEF), in group I was 47.52±5.85 while in group II it was 49.85±6.25. There was a statistically non-significant difference between the groups with a P value of 0.414. Mean Intensive Care Unit (ICU) period was 4.42±1.35 in group I, and group II was 2.73±0.95. The difference between the groups was statistically significantly shorter among group II (prophylaxis group) (P <0.01). Regarding development of POAF, in group I, the incidence of POAF was 85.3% while in group II, it was 38.2%. Difference among the two studied groups was statistically significantly lower in the group II (prophylaxis group). Conclusion: A prophylactic amiodarone strategy dramatically decreased incidence of POAF risk. All previous estimations of POAF risk reduction using prophylactic amiodarone were found to be accurate. Amiodarone was more effective in preventing postoperative atrial fibrillation with no serious side effects and it decreased postoperative ICU stay.

Prophylaxis for patients at Risk to Eliminate Post-operative Atrial Fibrillation (PREP-AF trial): a protocol for a feasibility randomized controlled study

BackgroundPostoperative atrial fibrillation (POAF) is a frequent adverse event after thoracic surgery with associated morbidity, mortality, and healthcare costs. It has been shown to be preventable with prophylactic amiodarone, which is only recommended in high-risk individuals due to the potential associated side effects. Risk factors for POAF have been identified and incorporated into a prediction model to identify high-risk patients. Further evaluation in the form of a multicenter clinical trial is required to assess the effectiveness of prophylaxis specifically in this high-risk population. The feasibility of such a trial first needs to be assessed.MethodsThe PREP-AF trial is a double-blind randomized controlled feasibility trial. Individuals undergoing major thoracic surgery who are identified to be high-risk by the POAF prediction model will be randomized 1:1 to receive a short course of amiodarone vs. placebo in the immediate postoperative period. The primary outcome is feasibility, which will be measured by the number of eligible patients identified, consented, and randomized; intervention adherence; and measurement of future outcomes of a full trial.DiscussionThis study will determine the feasibility of a randomized controlled trial to assess the effectiveness of prophylactic amiodarone, in high-risk patients undergoing major thoracic surgery. This will inform the development of a multi-center trial to establish if prophylactic amiodarone is safe and effective at reducing the incidence of POAF. Preventing this adverse event will not only improve outcomes for patients but also reduce the associated health resource utilization and costs.Trial registrationClinicalTrials.gov NCT04392921. Registered on 19 May 2020.

A Comparative Effectiveness Systematic Review and Meta-analysis of Drugs for the Prophylaxis of Junctional Ectopic Tachycardia.

Junctional Ectopic Tachycardia (JET) is an arrhythmia originating from the AV junction, which may occur following congenital heart surgery, especially when the intervention is near the atrioventricular junction. The aim of this systematic review and meta-analysis is to compare the effectiveness of amiodarone, dexmedetomidine, and magnesium in preventing JET following congenital heart surgery. This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, where 11 electronic databases were searched from the date of inception to August 2020. The incidence of JET was calculated with the relative risk of 95% Confidence Interval (CI). Quality assessment of the included studies was assessed using the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement. Eleven studies met the predetermined inclusion criteria and were included in this meta-analysis. Amiodarone, dexmedetomidine, and magnesium significantly reduced the incidence of postoperative JET [Amiodarone: risk ratio 0.34; I2= 0%; Z=3.66 (P=0.0002); 95% CI 0.19-0.60. Dexmedetomidine: risk ratio 0.34; I2= 0%; Z=4.77 (P<0.00001); 95% CI 0.21-0.52. Magnesium: risk ratio 0.50; I2= 24%; Z=5.08 (P<0.00001); 95% CI 0.39-0.66]. All three drugs have shown promising results in reducing the incidence of JET. Our systematic review found that dexmedetomidine is better in reducing the length of ICU stays as well as mortality. In addition, dexmedetomidine also has the least pronounced side effects among the three. However, it should be noted that this conclusion was derived from studies with small sample sizes. Therefore, dexmedetomidine may be considered as the drug of choice for preventing JET.

Intra-Operative Amiodarone-Releasing Hydrogel to Prevent Post Lung Transplant Atrial Fibrillation: A Pilot Clinical Trial

The purpose of this study was to evaluate the effectiveness of topical amiodarone applied to the atria and pulmonary veins at the time of lung transplantation (LTx) in decreasing postoperative atrial fibrillation (POAF). Twenty patients undergoing LTx at a single institution were enrolled in this prospective pilot study and compared to 40 historical controls. An Amiodarone-containing hydrogel was created using CoSeal Surgical Sealant (Baxter Healthcare) and Amiodarone, which was applied to the pulmonary vein anastomoses and atria at time of LTx in the study group. The primary endpoint was development of POAF. Data for the control group was obtained by retrospective chart review. The demographic and clinical information for both groups is demonstrated in Table 1. In the study group, 6 patients (30%) developed POAF (Figure 1), 2 (10%) of which lasted less than 24 hours in duration. In the control group, 18 (52.9%) patients developed POAF, 9 (26.5%) of which lasted less than 24 hours in duration. Three patients in the study group and 4 control patients required cardioversion. In the study group, 20% of patients were discharged home on an anti-arrhythmic medication compared to 47.1% in the control group. There were no adverse outcomes related to the application of Amiodarone Hydrogel. In this small pilot study, the intra-operative application of Amiodarone-containing hydrogel to the pulmonary vein anastomoses and atria appeared to decrease the rates of POAF when compared to historical controls from the same institution.

Comparison of Prophylactic Use of Intravenous N Acetylcysteine v/s Amiodarone in Preventing Post Operative Artrial Fibrillation after Coronary Artery Bypass Graft

Objective: compare the effectiveness of intravenous N-acetylcysteine and amiodarone in prevention of pos operative atrial fibrillation. Study Design: Randomized control trial Place and duration: study was conducted cardiac surgery department of Choudhary Pervaiz Elahi Institute of Cardiology, Multan from December 2017 to December 2018 in one year duration. Methodology: study was conducted on 130 patients. Patients were divided into two equal groups by lottery method. Study was started after permission from academic affairs committee written informed consent from the patients. Non probability consecutive sampling was used Study variables are age, gender, duration of ICU stay and mortality. An outcome variable was post operative atrial fibrillation. Data was computed on software SPSS version 23 and analyzed for all possible variables. P value ?0.05 was taken as significant. Results: POAF of amiodarone and NAC group was noted as 26.2% and 13.8%, respectively. The difference was statistically insignificant (0.079). Mortality of amiodarone and NAC groups was occurred as 7.7% and 4.6%, respectively. The difference was statistically insignificant (0.465). Conclusion: intravenous N-acetylcysteine is more effective in prevention of post operative atrial fibrillation as compared intravenous amiodarone but post operative stay is prolonged in patients of NAC.

Effectiveness of amiodarone in treatment of cutaneous leishmaniasis caused by Leishmania major

Development of new chemotherapeutic agents is an essential issue in the treatment and control of a disease. This study aimed to evaluate the anti-leishmanial activity of amiodarone, an antiarrhythmic class III drug, against Leishmania major, the most prevalent etiological agent of cutaneous leishmaniasis in the old world. The proliferation of promastigotes and intracellular amastigotes in the absence or presence of amiodarone was estimated, in an in vitro study. For in vivo study, five weeks after infection of BALB/c mice with L. major, when the lesions appeared at the injection site, the mice were divided into four groups (n = 6 each); treatment was conducted for 28 consecutive days with vehicle, amiodarone at 40 mg/kg orally and glucantime at 60 mg/kg intraperitoneally. Therapy with amiodarone reduced the size of lesions compared to the untreated group after 12 days. Amiodarone decreased the parasite load and inflammatory responses, particularly the macrophages containing amastigotes, and enhanced granulation tissue formation in the dermis and subcutaneous area. The Tumor necrosis factor-α and Interleukin-6 levels were significantly lower in the cell culture supernatants of the inguinal lymph node in the amiodarone treated group compared to the vehicle and untreated groups. Amiodarone significantly increased the activity of glutathione peroxidase in comparison to the vehicle and untreated groups but did not affect the plasma levels of superoxide dismutase, malondialdehyde, adiponectin, and ferric reducing ability of plasma. Therefore, the anti- L. major activity and immunomodulatory effects of amiodarone reduced the parasitic load and enhanced wound healing in cutaneous leishmaniasis in BALB/c mice. Amiodarone reduced the lesion surface area, but it did not cure it completely.

Use and Outcomes Associated With Perioperative Amiodarone in Cardiac Surgery.

BackgroundIn randomized controlled trials, perioperative administration of amiodarone has been shown to reduce the incidence of postoperative atrial arrhythmias and length of stay (LOS) among patients undergoing coronary bypass surgery. However, little is known about the use or effectiveness of perioperative amiodarone in routine clinical practice.Methods and ResultsWe studied patients ≥18 years old without a previous history of atrial or ventricular arrhythmias who underwent elective coronary bypass surgery between 2013 and 2014 within a network of 235 US hospitals. Perioperative amiodarone was defined as receipt of amiodarone either on the day of or the day preceding surgery. We used covariate‐adjusted modeling and instrumental variable methods to examine the association between receipt of amiodarone and the development of atrial arrhythmias, in‐hospital mortality, readmission, LOS, and cost. Of 12 758 patients, 2195 (17.2%) received perioperative amiodarone, 3330 (26.1%) developed atrial arrhythmias postoperatively, and the average LOS was 6.4 days (±2.6 days). Instrumental variable analysis showed that receipt of perioperative amiodarone was associated with lower risk of atrial arrhythmias (risk difference −11 percentage points, 95% CI −19 to −4 percentage points; P=0.002) and a shorter LOS (−0.7 day, 95% CI −1.39 to −0.01 days; P=0.048). There was no association between receipt of perioperative amiodarone and in‐hospital mortality, cost, or readmission.ConclusionsAmong patients undergoing coronary bypass surgery without previous arrhythmias, perioperative amiodarone is associated with a lower risk of atrial arrhythmias and shorter LOS. These findings are consistent with previous randomized trials and lend support to current guideline recommendations.

Procainamide Versus Amiodarone for Stable Ventricular Tachycardia.

Procainamide Versus Amiodarone for Stable Ventricular Tachycardia.

Amiodarone versus direct current cardioversion in treatment of atrial fibrillation after cardiac surgery

Aim: Postoperative atrial fibrillation is common after cardiac surgery and is associated with higher rates of complications and mortality. Despite the importance of postoperative atrial fibrillation, the most effective management strategy for this common surgical complication remains uncertain. The aim of this study was to evaluate the effectiveness of amiodarone and early direct current cardioversion to restore sinus rhythm in new onset postoperative atrial fibrillation.Material and Methods: This was a prospective, open-labeled randomized- controlled trial. A total of 50 patients who had new onset postoperative atrial fibrillation longer than 30 minutes were enrolled in the study; 26 patients were randomized to control group and 24 to amiodarone group. Patients in whom sinus rhythm did not return within 24 hours, then external electrical direct current cardioversion was performed for both groups. The primary endpoint of the study was a restoration of sinus rhythm at the 24th hour. Secondary endpoints needed for direct current cardioversion, success rate, sinus rhythm at discharge, sinus rhythm at 30th days and crossover rates.Results: There was a significantly higher number of patients with sinus rhythm at the 24th hour in the amiodarone group than the control group (79.2% vs. 46.2%, p=0.022). Need for direct current cardioversion (p=0.022) and crossover ratio (p=0.021) were significantly higher in control group than amiodarone group. Direct current cardioversion success rate, normal sinus rhythm at discharge and 1st month did not differ significantly between groups. Conclusion: Amiodarone therapy seems effective in restoring sinus rhythm within 24 hours and decreases the need for direct current cardioversion. Keywords: antiarrhythmic agents; atrial fibrillation; cardiovascular surgery; post-CABG

Effect of Prophylactic Amiodarone Infusion on the Recurrence of Ventricular Arrhythmias in Out-of-Hospital Cardiac Arrest Survivors: A Propensity-Matched Analysis.

Amiodarone is recommended for shock-refractory ventricular arrhythmia during resuscitation; however, it is unknown whether amiodarone is effective for preventing ventricular arrhythmia recurrence in out-of-hospital cardiac arrest (OHCA) survivors treated with targeted temperature management (TTM). We investigated the effectiveness of prophylactic amiodarone in preventing ventricular arrhythmia recurrence in OHCA survivors. Data of consecutive adult non-traumatic OHCA survivors treated with TTM between 2010 and 2016 were extracted from prospective cardiac arrest registries of four tertiary care hospitals. The prophylactic amiodarone group was matched in a 1:1 ratio by using propensity scores. The primary outcome was ventricular arrhythmia recurrence requiring defibrillation during TTM. Among 295 patients with an initially shockable rhythm and 149 patients with initially non-shockable-turned-shockable rhythm, 124 patients (27.9%) received prophylactic amiodarone infusion. The incidence of ventricular arrhythmia recurrence was 11.26% (50/444). Multivariate analysis showed prophylactic amiodarone therapy to be the independent factor associated with ventricular arrhythmia recurrence (odds ratio 1.95, 95% CI 1.04–3.65, p = 0.04), however, no such association was observed (odds ratio 1.32, 95% CI 0.57–3.04, p = 0.51) after propensity score matching. In this propensity-score-matched study, prophylactic amiodarone infusion had no effect on preventing ventricular arrhythmia recurrence in OHCA survivors with shockable cardiac arrest. Prophylactic amiodarone administration must be considered carefully.

Effectiveness of amiodarone and lidocaine combination in termination of monomorphic ventricular tachycardia electrical storm in patient with dilated cardiomyopathy and severe left ventricular dysfunction

Effectiveness of amiodarone and lidocaine combination in termination of monomorphic ventricular tachycardia electrical storm in patient with dilated cardiomyopathy and severe left ventricular dysfunction

Fractal properties and morphological investigation of nano-amiodarone using image processing

Many people hear their heartbeats when they are in certain emotional conditions such as joy, fear, or anxiety or are exercising. But if the heart rate constantly decreases or increases, it shows that the heart has an arrhythmia that, if ignored, may turn off the vital sound forever. Heart arrhythmia is one of the heart diseases, in which case the heart rhythm is abnormal. Amiodarone is one of the drugs used to maintain normal heartbeats in people with heart rhythm. In this study, we will explain a scrutiny on the effectiveness of amiodarone with the help of the “fractal dimension.” To better investigate the fractal dimensions, we converted this drug to nano-size, and then using a scanning electron microscope (SEM), performing of nano-amiodarone was identified. We calculated the fractal dimensions of nano-amiodarone using image processing values on a computer and histogram plot with SEM image using MATLAB software. We obtained new results from fractal dimensions and histogram diagrams of this nano-drug based on the SEM image. The primary objective of this study is to prove the relationship between fractal behavior and therapeutic effects of drugs in the body. This study could open up a new perspective between chemistry and mathematics sciences as well as pharmacy sciences in the development of treatment and release of medications in medical science in the near future.