Key result
Prophylactic Diltiazem, epidural Bupivacaine, and magnesium prevented atrial fibrillation in patients undergoing non-cardiac thoracic surgery, with a number needed to treat between 4 and 8.
Why the study?
Do prophylactic anti-arrhythmic drugs prevent atrial fibrillation in patients undergoing lung surgery?
Systematic Review
Do prophylactic anti-arrhythmic drugs prevent atrial fibrillation in patients undergoing lung surgery?
Effect estimate: NNT between 4 and 8
Prophylactic use of diltiazem, epidural bupivacaine, or magnesium may reduce the incidence of postoperative atrial fibrillation in patients undergoing non-cardiac thoracic surgery.
Supports prophylactic use to prevent postoperative AF after non-cardiac thoracic surgery; extends RCT evidence to this population.
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed whether prophylactic anti-arrhythmic drugs may prevent atrial fibrillation (AF) following lung resection. Altogether 457 papers were found using the reported search, of which 14 presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. We identified single randomized trials that have demonstrated a benefit for Diltiazem, Bupivacaine epidural and magnesium for prophylaxis against AF in patients undergoing non-cardiac thoracic surgery, with a number needed to treat of between 4 and 8 with these regimes.
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Shrivastava et al. (2004) conducted a systematic review in Atrial fibrillation. Prophylactic anti-arrhythmic drugs (Diltiazem, Bupivacaine epidural, magnesium) was evaluated on Atrial fibrillation (NNT between 4 and 8). Prophylactic Diltiazem, epidural Bupivacaine, and magnesium prevented atrial fibrillation in patients undergoing non-cardiac thoracic surgery, with a number needed to treat between 4 and 8.
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