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

Electrocautery maze and amiodarone will ensure a better controlled sinus rhythm throughout the immediate postoperative period and will make it smoother.

To study the effect of electrocautery maze procedure and amiodarone in RHD patients with AF undergoing mitral valve replacement surgery.

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.

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.

The combination of both electrocautery maze procedure and amiodarone may have a better control over atrial fibrillation than only electrocautery maze procedure alone.