Effect of electrocautery maze procedure and amiodarone in rheumatic valvular heart disease patients with atrial fibrillation undergoing mitral valve replacement surgery

Introduction: Electrocautery maze and amiodarone will ensure a better controlled sinus rhythm throughout the immediate postoperative period and will make it smoother. Objective: To study the effect of electrocautery maze procedure and amiodarone in RHD patients with AF undergoing mitral valve replacement surgery. Materials and Methods: This randomized prospective double blind clinical trial was carried out among 40 patients undergoing mitral valve replacement surgery in a tertiary care hospital. Randomization was done by using lottery method. Patients were randomly assigned in one of the following two groups. Group I: (CM, n = 20) Cautery maze procedure was done and 100ml normal saline infused over 20 min before induction. Group II: (CM + A, n = 20) Cautery maze procedure was done & Amiodarone 3 mg/kg body weight diluted in 100 ml normal saline infused over 20 minutes before induction. Results: In present study 75% patients in group I and 85% patients in group II were in sinus rhythm at ACC release. 10% patients in group I while 5% patient had ventricular tachycardia/fibrillation at ACC release. 1 patient in group I and no patient in group II had recurrence of AF within 3 days postoperatively. There was no statistically significant difference in the mean value of extubation time 9.95±1.31 in group I & 10.80±4.61 in group II & even in ICU stay 4.75±1.74 days in group I, 5.15±1.13 days in group II. Conclusion: The combination of both electrocautery maze procedure and amiodarone may have a better control over atrial fibrillation than only electrocautery maze procedure alone.