Amiodarone versus lidocaine and placebo for the prevention of ventricular fibrillation after aortic crossclamping: a randomized, double-blind, placebo-controlled trial.

William J. Mauermann, Juan N. Pulido, David W. Barbara, Martin D. Abel, Zhuo Li, Laurie A. Meade, Hartzell V Schaff, Roger D. White

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Ventricular fibrillation occurs commonly after aortic crossclamping in patients undergoing cardiac surgery. Ventricular fibrillation increases myocardial oxygen consumption, and defibrillation may harm the myocardium. Thus, a pharmacologic approach to decreasing the incidence of ventricular fibrillation or the number of shocks required may be beneficial. The goal of this study was to evaluate whether amiodarone or lidocaine was superior to placebo for the prevention of ventricular fibrillation after aortic crossclamping in patients undergoing a variety of cardiac surgical procedures. Patients undergoing cardiac surgery requiring aortic crossclamping were randomized to receive lidocaine 1.5 mg/kg, amiodarone 300 mg, or placebo before aortic crossclamp removal The primary outcomes were the incidence of ventricular fibrillation and the number of shocks required to terminate ventricular fibrillation. A total of 342 patients completed the trial. On multivariate analysis, there was no difference in the incidence of ventricular fibrillation among treatment groups. The number of required shocks was categorized as 0, 1 to 3, and greater than 3. On multivariate analysis, patients receiving amiodarone required fewer shocks to terminate ventricular fibrillation (odds ratio, 0.51; 95% confidence interval, 0.31-0.83; P = .008 vs placebo). There was no difference between lidocaine and placebo in the number of required shocks (odds ratio, 0.86; 95% confidence interval, 0.52-1.41; P = .541). In patients undergoing a variety of cardiac surgical procedures, neither amiodarone nor lidocaine reduced the incidence of ventricular fibrillation. Amiodarone decreased the number of shocks required to terminate ventricular fibrillation.

Original languageEnglish (US)
Pages (from-to)1229-1234
Number of pages6
JournalThe Journal of Thoracic and Cardiovascular Surgery
Volume144
Issue number5
StatePublished - 2012

Fingerprint

Amiodarone
Ventricular Fibrillation
Lidocaine
Placebos
Shock
Cardiac Surgical Procedures
Incidence
Thoracic Surgery
Multivariate Analysis
Odds Ratio
Confidence Intervals
Oxygen Consumption
Myocardium

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Amiodarone versus lidocaine and placebo for the prevention of ventricular fibrillation after aortic crossclamping : a randomized, double-blind, placebo-controlled trial. / Mauermann, William J.; Pulido, Juan N.; Barbara, David W.; Abel, Martin D.; Li, Zhuo; Meade, Laurie A.; Schaff, Hartzell V; White, Roger D.

In: The Journal of Thoracic and Cardiovascular Surgery, Vol. 144, No. 5, 2012, p. 1229-1234.

Research output: Contribution to journalArticle

Mauermann, William J. ; Pulido, Juan N. ; Barbara, David W. ; Abel, Martin D. ; Li, Zhuo ; Meade, Laurie A. ; Schaff, Hartzell V ; White, Roger D. / Amiodarone versus lidocaine and placebo for the prevention of ventricular fibrillation after aortic crossclamping : a randomized, double-blind, placebo-controlled trial. In: The Journal of Thoracic and Cardiovascular Surgery. 2012 ; Vol. 144, No. 5. pp. 1229-1234.
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