Local Use of Hydrogel with Amiodarone in Cardiac Surgery: Experiment and Translation to the Clinic (original) (raw)
Related papers
Circulation. Arrhythmia and electrophysiology, 2018
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Although treatment options for AF exist, many patients cannot be maintained in normal sinus rhythm. Amiodarone is an effective medication for AF but has limited clinical utility because of off-target tissue toxicity. Here, we use a pig model of AF to test the efficacy of an amiodarone-containing polyethylene glycol-based hydrogel. The gel is placed directly on the atrial epicardium through the pericardial space in a minimally invasive procedure using a specially designed catheter. Implantation of amiodarone-containing gel significantly reduced the duration of sustained AF at 21 and 28 days; inducibility of AF was reduced 14 and 21 days post-delivery. Off-target organ drug levels in the liver, lungs, thyroid, and fat were significantly reduced in animals treated with epicardial amiodarone gel compared with systemic controls in small-animal distribution studies. The pericardium is an underutilized therapeutic site and may...
2018
Author(s): Burdick, Austin | Advisor(s): Christman, Karen L | Abstract: Previous research into the problem of postsurgical cardiac adhesions has produced a hydrogel barrier that can be applied to the surface of the heart, preventing the formation of adhesions in the weeks following trauma during surgery. When developing this type of gel for clinical translation, two issues that must be addressed are the biocompatibility of the material as well as a method of hydrogel delivery to the tissue surface. Previous research yielded a hydrogel made from poly(ethylene glycol) functionalized with aldehyde, aminooxy and dopamine groups. Cell viability is reduced in culture treated with this material due to the inclusion of dopamine. Examination of the hydrogel in culture through fluorescence microscopy and spectrophotometry indicate that this is primarily due to oxidative stress, demonstrated by increased levels of hydrogen peroxide and lipid peroxidation. However, metabolic and morphological a...
Amiodarone in the Management of Cardiac Arrhythmia Following Open Heart Surgery
Cardiovascular Journal
Background: Postoperative cardiac arrhythmias may present as life threatening complications like- cerebrovascular strokes, thrombo-embolic manifestations, inadequate ventricular filling and compromised hemodynamic stability. Amiodarone is an effective drug for various postoperative arrhythmias. Objective of this study is to evaluate the efficacy of Amiodarone in controlling postoperative arrhythmia in our settings at the department of cardiac surgery. Methods: This retrospective observational study involved random selection of 20 patients, who developed potentially life-threatening arrhythmia following cardiac surgical procedures under cardiopulmonary bypass (CPB) at Chittagong Medical College Hospital (CMCH) between January 2018 and December 2020. Amiodarone was used in controlling postoperative cardiac arrhythmia by loading 1000 mg in first 24 hours, followed by 800 mg orally in daily divided doses. Results: Among 20 patients under study, five had valvular replacement, three had A...