Улучшение результатов хирургической коррекции сложных нарушений ритма и профилактика их рецидива у кардиохирургических пациентов

Aim: To examine results of surgical intervention in cardiac surgery patients with atrial fibrillation after a loading pre-operative dose of amiodarone. Material and methods: The study included 49 cardiac patients with atrial fibrillation who underwent a surgery during a 14 months’ period in 2013–2014. Group 1 (n = 23) received preoperative amiodarone saturation at a dose 0.6–1.0 g daily with a maintenance dose 0.4 g daily in early postoperative period and at a dose 0.2 g daily up to 6 months after surgery. Group 2 (control, n = 26) was on a postoperative maintenance dose of amiodarone 0.6–1.0 g daily. Results: Stable sinus rhythm after left atrial Maze IV procedure was established in 44/49 of patients (90%). Atrial fibrillation relapsed in 1 patient from group 1 and in 4 patients from group 2. All 5 patients with recurrence of persistent atrial fibrillation had a long-term persistent arrhythmic history of more than 3 years, and echocardiography revealed left atrial dilatation of more than 6 cm. Conclusion: The use of saturating doses of amiodarone before surgery improves outcomes of left atrial Maze IV procedure (up to 95%), compared to those in the control group where amiodarone was used postoperatively (up to 85%).