Practical regimen for amiodarone use in preventing postoperative atrial fibrillation
Research output: Contribution to journal › Journal article › Research › peer-review
BACKGROUND: Postoperative atrial fibrillation occurs in 5% to 65% of patients undergoing cardiac surgery. Although postoperative atrial fibrillation is often regarded as a temporary, benign, operation-related problem, it is associated with a twofold to threefold increase in risk of adverse events, including permanent or transient stroke, acute myocardial infarction, and death.
METHODS: This randomized, controlled, double-blinded trial included 250 eligible consecutively enrolled patients undergoing coronary artery bypass grafting (CABG). They received 300 mg of amiodarone/placebo administered intravenously over 20 minutes on the first postoperative day and an oral dose of 600 mg of amiodarone or placebo twice daily for the first 5 postoperative days.
RESULTS: The patients in amiodarone prophylaxis experienced a reduction in risk of atrial fibrillation of 14% (95% confidence interval [CI], 5.0% to 24%), with the number needed to treat at 6.9 (95% CI, 4.2 to 20), and the results for symptomatic atrial fibrillation showed a risk reduction of 18% (95% CI, 9.4% to 26), with the number needed to treat at 5.7 (95% CI, 3.9 to 11). Of the patients who developed atrial fibrillation in the placebo group, 84% experienced a symptomatic attack versus only 43% in the amiodarone group.
CONCLUSIONS: Postoperative prophylaxis with a high dose of oral amiodarone after an intravenous bolus infusion is a safe, practical, feasible, and effective regimen for CABG patients. It significantly diminishes the occurrence of postoperative atrial fibrillation.
Original language | English |
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Journal | The Annals of Thoracic Surgery |
Volume | 83 |
Issue number | 4 |
Pages (from-to) | 1326-31 |
Number of pages | 6 |
ISSN | 0003-4975 |
DOIs | |
Publication status | Published - Apr 2007 |
- Administration, Oral, Adult, Aged, Aged, 80 and over, Amiodarone/administration & dosage, Anti-Arrhythmia Agents/administration & dosage, Atrial Fibrillation/drug therapy, Cardiac Surgical Procedures/adverse effects, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications/prevention & control, Proportional Hazards Models, Prospective Studies, Reference Values, Risk Assessment, Statistics, Nonparametric, Treatment Outcome
Research areas
ID: 242780592