Abstract:
OBJECTIVES:The objective of this study was to determine the frequency of pulmonary complications, feasibility of early hospital discharge and requirements for postoperative inotropic and chronotropic support in patients receiving amiodarone therapy before heart transplantation. BACKGROUND:Although many patients waiting for heart transplantation will die of arrhythmias before a donor heart is found, the use of amiodarone has been limited by concern about increased complications in the perioperative period. METHODS:The 29 patients receiving amiodarone at the time of heart transplantation at University of California, Los Angeles Medical Center between October 1986 and September 1990 were compared with 29 control recipients to evaluate postoperative morbidity. Patients were receiving amiodarone for recurrent ventricular tachyarrhythmias (n = 11), atrial fibrillation (n = 2) or complex ventricular ectopic activity (n = 16). The average daily dose was 360 +/- 230 mg/day for an average of 11 +/- 22 months before transplantation. Amiodarone and control groups had a similar ejection fraction (0.18 +/- 0.07 vs. 0.20 +/- 0.08), frequency of coronary disease, age and gender. There were three more status I patients in the control group. OKT3 was given to only two patients receiving amiodarone and 12 control patients at high risk for renal dysfunction. RESULTS:Postoperatively, the duration of assisted ventilation was 21 +/- 19 h after amiodarone therapy versus 26 +/- 2 h in the control group (20 +/- 18 h vs. 15 +/- 9 h after excluding patients receiving OKT3), discharge arterial oxygen saturation was > 95% in both groups. Two patients in the amiodarone group with a smoking history of > 100 pack-years developed bilateral pulmonary infiltrates of brief duration. Although patients receiving amiodarone required atrial pacing more frequently (eight vs. two patients) and had a lower heart rate at discharge (75 +/- 18 vs. 86 +/- 11 beats/min), the duration of inotropic support (2.1 +/- 1.5 vs. 3.5 +/- 2.5 days) and of hospital stay (10 +/- 3 vs. 15 +/- 10 days) was not higher in the amiodarone than in the control group. The mortality rate at 30 days was similar in the two groups (6.8% vs. 3.4%, p = NS). CONCLUSIONS:Amiodarone therapy before heart transplantation may contribute to occasional pulmonary complications but does not significantly increase perioperative morbidity or mortality with the regimens used in this retrospective study.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Chelimsky-Fallick C,Middlekauff HR,Stevenson WG,Kobashigawa J,Saxon LA,Moriguchi J,Brownfield ED,Hamilton MA,Drinkwater D,Laks Hdoi
10.1016/0735-1097(92)90450-2subject
Has Abstract,Author List Incompletepub_date
1992-12-01 00:00:00pages
1556-61issue
7eissn
0735-1097issn
1558-3597pii
0735-1097(92)90450-2journal_volume
20pub_type
临床试验,杂志文章abstract::Fifty patients with anteroapical left ventricular aneurysm secondary to prior myocardial infarction underwent aneurysmectomy, at which time endocardial sinus rhythm mapping was performed. Forty patients had a history of recurrent sustained monomorphic ventricular tachycardia, and 10 had an aneurysm but no history of s...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(88)90409-3
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abstract:OBJECTIVES:This study was performed to determine whether cardiac surgery improves functional capacity in patients > 70 years of age and to identify factors associated with good and poor functional results in this age group. BACKGROUND:Cardiac surgery has been used increasingly among older patients, but the effectivene...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90548-7
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abstract::To evaluate the feasibility of detecting denervated myocardium in the infarcted canine heart, the distribution of sympathetic nerve endings using I-123 metaiodobenzylguanidine (MIBG) was compared with the distribution of perfusion using thallium-201, with the aid of color-coded computer functional map in 16 dogs. Twel...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80156-1
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abstract:OBJECTIVES:The purpose of this study was to determine the frequency of mutations in the low-density lipoprotein receptor (LDLR) and apolipoprotein B (APOB) genes in consecutive patients with a clinical diagnosis of familial combined hyperlipidemia (FCH) in a nonresearch setting. BACKGROUND:The lipid phenotype frequent...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2008.06.050
更新日期:2008-11-04 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/0735-1097(95)00124-i
更新日期:1995-07-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(02)01756-4
更新日期:2002-04-17 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(97)82760-x
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
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更新日期:1997-11-15 00:00:00
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(90)90222-b
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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更新日期:2013-07-30 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
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journal_title:Journal of the American College of Cardiology
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更新日期:2000-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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