Abstract
Objective: The aim of the study was to evaluate the role of intravenous amiodarone in acute onset atrial fibrillation in patients with structurally normal hearts.
Methodology: This cross sectional was conducted in Cardiology Department, Hayatabad Medical Complex Peshawar from 1st April 2005 to 31st March 2006. All adult patients with acute onset atrial fibrillation and with no rheumatic or congenital valvular heart disease were included in the study. Role of intravenous amiodarone was defined as whether it caused sinus rhythm conversion or ventricular rate control. Transthoracic echocardiography was performed to exclude any structural heart disease. Haemodynamically stable patients with atrial fibrillation of less than 48 hours were treated with intravenous amiodarone. Decision regarding sinus rhythm conversion or otherwise was done at 24 hours. Patients with no response were to switch over to other option like electrical cardioversion.
Results: A total of 75 patients with acute onset atrial fibrillation were studied. There were 62 male with male to female ratio 4.7: 1. Majority of the patients i.e 42 (57.34%) were of age 55 years or above. Common clinical presentation was palpitation (100%), while 62(82.66%) patients had chest pain and 62(82.66%) had dyspnoea. Commonly observed risk factors were hypertension in 63 patients (84%), coronary artery disease in 48 patients (65.33%) and diabetes mellitus in 12 patients (16%). Sinus rhythm conversion was observed in 58 patients (77.33%) while 17 patients (22.66%) were noted to have achieved only rate control.
Conclusion: Amiodarone is effective in sinus rhythm conversion in acute onset atrial fibrillation in haemodynamically stable patients with no structural cardiac abnormality.