ROLE OF INTRAVENOUS AMIODARONE IN ACUTE ONSET ATRIAL FIBRILLATION

Abstract

Objective: The aim of the study was to evaluate the role of intravenousamiodarone in acute onset atrial fibrillation in patients with structurally normalhearts.

Methodology: This cross sectional was conducted in Cardiology Department,Hayatabad Medical Complex Peshawar from 1st April 2005 to 31st March 2006.All adult patients with acute onset atrial fibrillation and with no rheumatic orcongenital valvular heart disease were included in the study. Role of intravenousamiodarone was defined as whether it caused sinus rhythm conversion orventricular rate control. Transthoracic echocardiography was performed toexclude any structural heart disease. Haemodynamically stable patients withatrial fibrillation of less than 48 hours were treated with intravenous amiodarone.Decision regarding sinus rhythm conversion or otherwise was done at 24 hours.Patients with no response were to switch over to other option like electricalcardioversion.

Results: A total of 75 patients with acute onset atrial fibrillation were studied.There were 62 male with male to female ratio 4.7: 1. Majority of the patients i.e 42(57.34%) were of age 55 years or above. Common clinical presentation waspalpitation (100%), while 62(82.66%) patients had chest pain and 62(82.66%)had dyspnoea. Commonly observed risk factors were hypertension in 63patients (84%), coronary artery disease in 48 patients (65.33%) and diabetesmellitus in 12 patients (16%). Sinus rhythm conversion was observed in 58patients (77.33%) while 17 patients (22.66%) were noted to have achieved onlyrate control.

Conclusion: Amiodarone is effective in sinus rhythm conversion in acute onsetatrial fibrillation in haemodynamically stable patients with no structural cardiacabnormality.