Key result
Amiodarone effectively treats postoperative AT in young patients but adverse effects limit older patient use.
Amiodarone is effective for postoperative atrial flutter in young patients, but its use in older patients is limited by side effects, prompting consideration of lower doses or radiofrequency ablation.
Supports amiodarone dosing in young postoperative patients; leaves open safer alternatives and prospective trials for older adults.
Atrial flutter, including all types of postoperative atrial tachycardias, is the one with the highest risk of late sudden death. Thus, late postoperative atrial tachycardias must be suppressed and all patients should be permanently treated after a first episode of atrial flutter. Daily oral doses of 200-250 mg/m2 amiodarone were found to be highly effective and well tolerated in young patients. However, in older patients and after long-term therapy, its use is restricted by adverse side-effects. In these cases, association of lower doses of antiarrhythmic agents, including amiodarone, may be effective and well tolerated. The use of other therapeutic options such as radiofrequency ablation should also be considered in older patients having drug-refractory postoperative atrial flutter.
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E Villain (1997) conducted a review in Postoperative atrial tachycardias and atrial flutter. Amiodarone was evaluated. Daily oral doses of 200-250 mg/m2 amiodarone are highly effective for postoperative atrial tachycardias in young patients, though adverse effects restrict its use in older patients.
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