RELAPSE PREVENTION AND IMPROVEMENT OF RESULTS OF COMPLEX ARRHYTHMIAS’ SURGICAL CORRECTION IN CARDIAC PATIENTS

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Abstract

Aim: To examine results of surgical intervention in cardiac surgery patients with atrial fibrillation after a loading pre-operative dose of amiodarone.

Material and methods: The study included 49 cardiac patients with atrial fibrillation who underwent a surgery during a 14 months’ period in 2013–2014. Group 1 (n = 23) received preoperative amiodarone saturation at a dose 0.6–1.0 g daily with a maintenance dose 0.4 g daily in early postoperative period and at a dose 0.2 g daily up to 6 months after surgery. Group 2 (control, n = 26) was on a postoperative maintenance dose of amiodarone 0.6–1.0 g daily.

Results: Stable sinus rhythm after left atrial Maze IV procedure was established in 44/49 of patients (90%). Atrial fibrillation relapsed in 1 patient from group 1 and in 4 patients from group 2. All 5 patients with recurrence of persistent atrial fibrillation had a long-term persistent arrhythmic history of more than 3 years, and echocardiography revealed left atrial dilatation of more than 6 cm.

Conclusion: The use of saturating doses of amiodarone before surgery improves outcomes of left atrial Maze IV procedure (up to 95%), compared to those in the control group where amiodarone was used postoperatively (up to 85%).

About the authors

N. A. Trofimov

Republican Cardiology Dispensary

Author for correspondence.
Email: nikolai.trofimov@mail.ru

Cardiovascular Surgeon

Russian Federation

A. P. Medvedev

Nizhny Novgorod State Medical Academy

Email: mail@skkbnn.ru

MD, PhD, Professor, Head of Chair of Hospital Surgery named after B.A. Korolyov

Russian Federation

V. E. Babokin

Moscow Regional Research and Clinical Institute (MONIKI)

Email: babokin@bk.ru

PhD, Head of Department of Cardiac Surgery

Russian Federation

O. I. Demarin

Nizhny Novgorod State Medical Academy

Email: fake@neicon.ru
Cardiovascular Surgeon Russian Federation

N. Kh. Zhamlikhanov

Municipal Pediatric Hospital No. 4

Email: fake@neicon.ru

MD, PhD, Professor, Chief Physician

Russian Federation

A. G. Dragunov

Republican Cardiology Dispensary

Email: fake@neicon.ru

PhD, Head of Department of Cardiac Surgery No. 2

Russian Federation

M. V. Gartfelder

Republican Cardiology Dispensary

Email: fake@neicon.ru

Cardiovascular Surgeon

Russian Federation

O. V. Nikolaeva

Republican Cardiology Dispensary

Email: fake@neicon.ru
Cardiologist Russian Federation

M. V. Dragunova

Republican Cardiology Dispensary

Email: fake@neicon.ru
Cardiologist Russian Federation

References

  1. Naccarelli GV, Varker H, Lin J, Schulman KL. Increasing prevalence of atrial fibrillation and flutter in the United States. Am J Cardiol. 2009;104(11):1534–9.
  2. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart. 2001;86(5):516–21.
  3. Nieuwlaat R, Capucci A, Camm AJ, Olsson SB, Andresen D, Davies DW, Cobbe S, Breithardt G, Le Heuzey JY, Prins MH, Levy S, Crijns HJ; European Heart Survey Investigators. Atrial fibrillation management: a prospective survey in ESC member countries: the Euro Heart Survey on Atrial Fibrillation. Eur Heart J. 2005;26(22):2422–34.
  4. Всероссийское научное общество специалистов по клинической электрофизиологии, аритмологии и кардиостимуляции (ВНОА). Клинические рекомендации по проведению электрофизиологических исследований, катетерной абляции и применению имплантируемых антиаритмических устройств (редакция 2011). М.; 2011. 518 с. Vserossiyskoe nauchnoe obshchestvo spetsialistov po klinicheskoy elektrofiziologii, aritmologii i kardiostimulyatsii (VNOA) [All-Russian Scientific Society of Specialists in Clinical Electrophysiology, Arrhythmology and Cardiac Pacing]. Klinicheskie rekomendatsii po provedeniyu elektrofiziologicheskikh issledovaniy, kateternoy ablyatsii i primeneniyu implantiruemykh antiaritmicheskikh ustroystv. [Clinical guidelines on electrophysiological assessment, catheter ablation and the use of implanted anti-arrhythmic devices]. Moscow;
  5. 153 p. (in Russian).
  6. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, Le Heuzey JY, Ponikowski P, Rutten FH. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31(19):2369–429.
  7. Gassanov N, Caglayan E, Duru F, Er F. Atrial fibrillation. Cardiol Res Pract. 2013;2013:142673.
  8. Levy S. Changing epidemiology of atrial fibrillation. Europace. 2013;15(4):465–6.
  9. Reinhold T, Lindig C, Willich SN, Bruggenjurgen B. The costs of atrial fibrillation in patients with cardiovascular comorbidities – a longitudinal analysis of German health insurance data. Europace. 2011;13(9):1275–80.
  10. Ringborg A, Nieuwlaat R, Lindgren P, Jonsson B, Fidan D, Maggioni AP, Lopez-Sendon J, Stepinska J, Cokkinos DV, Crijns HJ. Costs of atrial fibrillation in five European countries: results from the Euro Heart Survey on atrial fibrillation. Europace. 2008;10(4):403–11.
  11. Chua YL, Schaff HV, Orszulak TA, Morris JJ. Outcome of mitral valve repair in patients with preoperative atrial fibrillation. Should the maze procedure be combined with mitral valvuloplasty? J Thorac Cardiovasc Surg. 1994;107(2):408–15.
  12. Stewart S, Hart CL, Hole DJ, McMurray JJ. A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study. Am J Med. 2002;113(5):359–64.
  13. Betriu A, Chaitman BR, Almazan A. Preoperative determinants of return to sinus rhythm after valve replacement. In: Cohn LH, Gallucci V, editors. Cardiac Bioprosthesis. New York: Yorke Medical Books; 1982. p. 184–91.
  14. Eguchi K, Ohtaki E, Matsumura T, Tanaka K, Tohbaru T, Iguchi N, Misu K, Asano R, Nagayama M, Sumiyoshi T, Kasegawa H, Hosoda S. Pre-operative atrial fibrillation as the key determinant of outcome of mitral valve repair for degenerative mitral regurgitation. Eur Heart J. 2005;26(18):1866–72.
  15. cardiolog.org [Internet]. Available from: http://cardiolog.org/cardiohirurgia/51-xirurgicheskaja-aritmologija/211-xirurgicheskoe-lechenie-ma.html?start=1
  16. Schaff HV, Dearani JA, Daly RC, Orszulak TA, Danielson GK. Cox-Maze procedure for atrial fibrillation: Mayo Clinic experience. Semin Thorac Cardiovasc Surg. 2000;12(1):30–7.
  17. Cox JL. Intraoperative options for treating atrial fibrillation associated with mitral valve disease. J Thorac Cardiovasc Surg. 2001;122(2):212–5.
  18. Gaita F, Riccardi R, Caponi D, Shah D, Garberoglio L, Vivalda L, Dulio A, Chiecchio A, Manasse E, Gallotti R. Linear cryoablation of the left atrium versus pulmonary vein cryoisolation in patients with permanent atrial fibrillation and valvular heart disease: correlation of electroanatomic mapping and long-term clinical results. Circulation. 2005;111(2):136–42.
  19. Gerstenfeld EP, Hill MR, French SN, Mehra R, Rofino K, Vander Salm TJ, Mittleman RS. Evaluation of right atrial and biatrial temporary pacing for the prevention of atrial fibrillation after coronary artery bypass surgery. J Am Coll Cardiol. 1999;33(7):1981–8.
  20. Иваницкий ЭА, Покушалов ЕА, Туров АН, Сакович ВА. Способ профилактики фибрилляции предсердий после кардиохирургических вмешательств. Патент РФ № 2355438, МПК A61N1/05. 20.05.2009. Ivanitskiy EA, Pokushalov EA, Turov AN, Sakovich VA. Sposob profilaktiki fibrillyatsii predserdiy posle kardiokhirurgicheskikh vmeshatel'stv [Method of prevention of auricle fibrillation after cardiosurgical interferences]. Patent RU No 2355438, MPK A61N1/05. 2009 May 20 (in Russian).

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Copyright (c) 2015 Trofimov N.A., Medvedev A.P., Babokin V.E., Demarin O.I., Zhamlikhanov N.K., Dragunov A.G., Gartfelder M.V., Nikolaeva O.V., Dragunova M.V.

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