Dronedarone and Captisol-enabled Amiodarone in an experimental Cardiac Arrest.
OBJECTIVE:: To compare the energy required for defibrillation and post shock outcomes following the administration of dronedarone, amiodarone and placebo in a porcine model of cardiac arrest. METHODS:: Forty-two pigs were randomised either amiodarone, dronedarone or control treatments. Following induction of ventricular fibrillation, compressions and ventilations were performed for 3 minutes and treatment was administered over 30 seconds. If defibrillation was unsuccessful, cardiopulmonary resuscitation continued and repeated shocks were administered every 2 minutes with continual haemodynamic monitoring for a total duration of 30 minutes. RESULTS:: The cumulative energy required for defibrillation was 570J ± 422 for dronedarone, 441J ± 365 for amiodarone and 347J ± 281 for control (p=ns). Survival at 30 minutes was 1 (7.1%) for dronedarone compared with 11 (78.6%) for control (p=0.001). Mortality in the dronedarone group was due to refibrillation in 3 (21.4%) cases, atrioventricular (AV) block in 1 (7.1 %) cases and hypotension not due to bradycardia in 9 (64.3%) cases.Two minutes post successful defibrillation, systolic aortic pressure was lower in dronedarone versus control (86.6±26.9 mm Hg versus 110±15.1 mm Hg; p=0.035). CONCLUSIONS:: The administration of dronedarone resulted in a significant reduction in survival and both systolic aortic and coronary perfusion pressure compared with control.
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