Amiodarone for the Prevention of Reperfusion Ventricular Fibrillation

ObjectiveThe purpose of this study was to evaluate the efficacy of prophylactic single-dose amiodarone administered through the pump circuit before releasing the aortic cross-clamp (ACC) in preventing the occurrence of reperfusion ventricular fibrillation (RVF).DesignA prospective, randomized double-blind, placebo-controlled efficacy study.SettingA tertiary level teaching hospital.InterventionSeventeen patients received 150 mg of amiodarone in 10 mL of normal saline by way of the pump 3 minutes before releasing the ACC, and a control group of 17 patients received 10 mL of normal saline.Measurement and Main ResultsThe primary outcome of the study was the incidence of ventricular fibrillation requiring defibrillation during the 30-minute period after myocardial reperfusion. A large decrease in RVF (65% to 18%) was observed in the amiodarone-treated group with the number needed to treat only 2.1.The myocardial performance in terms of cardiac output was better in the amiodarone group; this could be attributed to the lower incidence of RVF and subsequent direct current shock therapy.ConclusionsThe observations showed that single-dose prophylactic amiodarone administered through the pump circuit 3 minutes before ACC release was an effective therapy to reduce the incidence of post-ACC release ventricular arrhythmias.