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Amiodarone therapy does not compromise subsequent heart transplantation
C Chelimsky-Fallick1, H R Middlekauff, W G Stevenson
1Ahmanson-UCLA Cardiomyopathy Center, Division of Cardiology, University of California, Los Angeles Medical Center.
Journal of the American College of Cardiology
|December 1, 1992
Summary
Amiodarone therapy before heart transplantation is safe, with no significant increase in perioperative complications or mortality. Occasional pulmonary issues may arise, but early discharge is feasible.
Area of Science:
- Cardiology
- Thoracic Surgery
- Pharmacology
Background:
- Amiodarone use is limited due to concerns about perioperative complications in heart transplant candidates.
- Many patients awaiting heart transplantation die from arrhythmias.
Purpose of the Study:
- To assess pulmonary complications, early discharge feasibility, and inotropic/chronotropic support needs in heart transplant recipients on amiodarone.
- To compare perioperative morbidity in amiodarone recipients versus controls.
Main Methods:
- Retrospective study comparing 29 heart transplant recipients on amiodarone with 29 controls.
- Patients received amiodarone for various arrhythmias at an average dose of 360 mg/day.
- Groups were similar in ejection fraction, coronary disease, age, and gender.
Main Results:
- No significant difference in duration of assisted ventilation or hospital stay between groups.
- Two amiodarone patients with heavy smoking history developed brief pulmonary infiltrates.
- Amiodarone patients required more atrial pacing and had lower discharge heart rates, but inotropic support duration was similar.
Conclusions:
- Amiodarone therapy before heart transplantation may cause rare pulmonary complications.
- Perioperative morbidity and mortality are not significantly increased with amiodarone regimens used.
- Early hospital discharge is feasible for heart transplant recipients on amiodarone.