Intravenous and Oral Amiodarone for the Prevention of Postoperative Atrial Fibrillation in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery
DOI:
https://doi.org/10.1532/HSF98.20071060Abstract
Background. Atrial fibrillation is still a frequent complication that increases morbidity after coronary artery bypass grafting. This prospective randomized study is designed to define efficacy of postoperative amiodarone prophylaxis in preventing atrial fibrillation after off-pump coronary artery bypass grafting.
Methods. One hundred forty-four patients who underwent elective off-pump coronary artery bypass grafting were enrolled for the study. Seventy-six patients (amiodarone group) received 5 mg/kg loading amiodarone infusion in the first postoperative hour, followed by 10 mg/kg for the first 24 hours. After 24 hours, patients received 600 mg/day amiodarone orally for 7 days and 200 mg/day until the end of the postoperative first month. Sixty-eight patients received placebo (control group).
Results. Preoperative characteristics and operative variables of the patients were similar in both groups. Incidence of new-onset atrial fibrillation and maximal ventricular rate response were recorded. The incidence of new-onset atrial fibrillation (11.8% versus 26.5%) (P = .025) and maximal ventricular rate response (109 ± 13.8 beats/min versus 124.5 ± 13.9 beats/min) (P = .011) were significantly lower in the amiodarone group. Duration of atrial fibrillation was 17.5 ± 8.1 hours for the amiodarone group compared with 32.7 ± 12 hours for the control group (P = .002).
Conclusion. Postoperative intravenous amiodarone prophylaxis followed by oral amiodarone significantly reduces the incidence of atrial fibrillation after off-pump coronary artery bypass grafting and the ventricular rate during atrial fibrillation.
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