[HSF] AF prophylaxis -valve patients

[prasannasimha]

There is an occasional patient who develops amiadorone induced pulmonary 
toxicity but this is not a common event and the key to treating it is to 
stop Amiadorone when any fluffy shadows are seen on the CXray. 
Amiadorone has been proven to be effective periop and I do give it to 
all patients with Afib, aortic surgery and preop ventricular ectopics 
etc. We do not give it for CABG because for some unrecognized reason we 
do not have a high incidence of Afib in India to justify it.
Prasanna
Ani Anyanwu wrote:
> Your statements are not supported by the data. there are at least two randomized trials showing benefit of pre-op amiodarone neither of which showed increase in ARDS. Indeed the evidence is that all patients should recieve pre-operative amiodarone and I know of one US center (not mine) where all patients are admitted to hospital a day before surgery for this therapy (this is reimbursed by insurance companies because the study published in JAMA a year or so ago showed clear benefit including reduced cost and reduced hospital stay becuase of the low incidence of AF).
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> Ani
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>> Date: Thu, 19 Jul 2007 16:44:20 +0100> From: drdharris at yahoo.co.uk> Subject: Re: [HSF] AF prophylaxis -valve patients> To: OpenHeart-L at lists.hsforum.com> CC: > > You said pre operatively. I would not us amiodarone,> as there is an increased incidence of ARDS in patients> put on bypass who have amiodarone in their system.> > I would use dig pre operatively if mitral regurg, and> b blocker if mitral stenosis> > Dave Harris> > > --- sekhar le <sekharle2006 at hotmail.com> wrote:> > > > > > > can we use digoxin or amiodarone pre operatively > > in valve patients with sinus rhythm for prophylaxis> > against post op AF? > >> _________________________________________________________________> > Call friends with PC-to-PC calling -- FREE> > http://get.live.com/messenger/overview> > _______________________________________________> > OpenHeart-L mailing list> > > > Send postings to:> > OpenHeart-L at lists.hsforum.com> > > > To UNSUBSCRIBE, to CHANGE email address, or to view> > archives:> > http://mmp.cjp.com/mailman/listinfo/openheart-l> > > > All messages transmitted by the OpenHeart-L are> > subject to the policies and > > disclaimers posted at:> > http://www.hsforum.com/listdisclaim> > -----------------------------------------> > > > > Dr. David G. Harris, FCS, MMED,> Cardiothoracic Surgeon > Suite 207 > Kuils River Private Hospital, > PO Box 1200, Kuils River, 7579, Cape Town, South Africa. > Tel +27-21-9006411 > Fax +27-21-9006412 Mobile +27-83-3309587> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------
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