Efficacy Analysis Of Magnesium Sulfate Combined With Amiodarone In The Treatment Of New-onset Rapid Atrial Fibrillation After Cardiopulmonary Bypass

Objective:To investigate the clinical efficacy and safety of amiodarone alone and magnesium sulfate in the treatment of new rapid atrial fibrillation after cardiopulmonary bypass.Methods:Eighty patients with new rapid atrial fibrillation after cardiopulmonary bypass in the Affiliated Hospital of Youjiang Medical University for Nationalities from January 2020 to August 2021 were randomly divided into control group(n = 40)and observation group(n =40).The patients in the control group were treated with amiodarone.Amiodarone 150 mg was diluted in 5% glucose injection 20 ml for the first time and then slowly injected into 10 min,and then maintained by intravenous drip of 0.8mg/min.Gradually reduce the dose according to the degree of recovery of the patient’s condition.The total amount of infusion did not exceed 1200 mg within 24 hours.During the treatment period,the changes of arterial blood pressure,blood oxygen saturation and ECG were closely monitored to ensure the clinical effect.After the symptoms of arrhythmia were controlled,amiodarone hydrochloride tablets were taken orally,200mg/,3 times a day,and reduced to 2 times a day after 7 days,and then changed to once a day after 7 days.On the basis of the control group,the observation group was treated with 25% magnesium sulfate injection,25% magnesium sulfate 20 ml and 5%glucose diluted to 50 ml intravenous drip,once a day.After the symptoms of arrhythmia were controlled,amiodarone hydrochloride tablets were taken orally,200 mg,3 times a day,and reduced to 2 times a day after 7 days,and then changed to once a day after 7 days.Patients in both groups were treated with drugs continuously for 3 months.The time needed for atrial fibrillation rhythm to return to normal sinus rhythm,the changes of heart rate,systolic blood pressure,diastolic blood pressure,electrolyte and hourly urine volume before and after treatment,and the changes of ECG at 1,2 and 3 months after discharge were compared.the occurrence of adverse reactions and so on.Results:The heart rhythm of both the observation group and the control group were recovered after treatment,but the recovery time of the observation group was lower than that of the control group.The difference was significant(t=-5.767,P<0.05);the heart rates of the two groups were significantly improved compared with before,the observation group was lower than before treatment(t=14.941,P<0.05),the control group(t=12.804,P<0.05),there was no significant difference in the improvement of the overall heart rate between the observation group and the control group(t=0.490,P>0.05);there were no significant changes in diastolic blood pressure,sodium ion,potassium ion and calcium ion in the two groups before and after treatment,the difference was not significant,the observation group(t=-1.455,t=0.777,t=-2.016,t=0.657,P>0.05),the control group(t=-1.585,t=-0.762,t=-1.537,t=-1.259,P>0.05);after treatment,the systolic blood pressure,hourly urine volume and serum magnesium ion in the observation group were higher than before,and the difference was significant(t=-4.783,t=-6.851,t =-3.967,P<0.05),the systolic blood pressure,hourly urine volume and serum magnesium ion concentration in the control group were also higher than before,and the difference was significant(t=-3.647,t=-11.127,t=-8.251,P<0.05),and the hourly urine volume of the observation group was significantly higher than that of the control group after treatment,the difference was significant(t=2.702,P<0.05),but the increase of blood pressure and the change of magnesium ions in the two groups after treatment were not significant.Differences(t=-1.537,t=-1.259,P>0.05);ECG was reviewed 1 and 2 months after discharge,some patients in the two groups had arrhythmia,but there was no significant difference in the total arrhythmia incidence(χ~2=0.054,P>0.05),(χ~2=2.581,P>0.05),both groups were in sinus rhythm 3 months after discharge;both groups had adverse reactions of varying degrees,but the total incidence of adverse reactions in the two groups There was no significant difference in the rate(χ~2=0.392,P>0.05).Conclusion:Short-term use of amiodarone in the treatment of new atrial fibrillation after cardiopulmonary bypass is safe and effective,and magnesium sulfate can enhance the therapeutic effect of amiodarone without increasing the incidence of adverse reactions of amiodarone.