Key result
A review of four studies found variable findings on the effect of intraoperative topical amiodarone therapy on the incidence of postoperative atrial fibrillation following cardiac surgery.
Why the study?
Postoperative atrial fibrillation frequently complicates cardiac surgery, but the efficacy and safety of intraoperative topical amiodarone for preventing it remain unclear.
Does intraoperative topical amiodarone prevent postoperative new-onset atrial fibrillation in patients undergoing cardiac surgery?
Systematic Review
Does intraoperative topical amiodarone prevent postoperative new-onset atrial fibrillation in patients undergoing cardiac surgery?
Current evidence from four studies shows variable findings regarding the efficacy and safety of topical amiodarone for preventing post-operative atrial fibrillation, highlighting the need for further investigation.
Inconsistent findings should not alter practice; leaves open whether topical amiodarone reduces postoperative AF.
BACKGROUND: Postoperative atrial fibrillation (POAF) is one of the most common complications following cardiac surgery and is associated with increased morbidity. Intraoperative topical amiodarone application on epicardial tissue has been shown to reduce systemic concentrations while maintaining therapeutic myocardial concentrations, thereby, lowering the risk of extracardiac adverse effects associated with oral and intravenous amiodarone therapy. However, the efficacy and safety of topical amiodarone in preventing POAF is unclear. OBJECTIVES: This study summarizes the clinical studies to-date that have investigated the efficacy and safety of topical amiodarone administration in preventing POAF following cardiac surgery. METHODS: A database search was conducted using Medline, Embase, and Cochrane Library to identify relevant studies. Abstracts were screened and data were extracted from relevant full-text articles that met the inclusion and exclusion criteria. RESULTS: The search returned four studies with variable findings on the effect of topical amiodarone therapy on the incidence of POAF, cardiac effects, extracardiac effects, and hospital length of stay. CONCLUSION: Prophylactic topical application of amiodarone may be effective and safe for preventing post-operative new-onset atrial fibrillation. Further investigation is required to evaluate the efficacy and safety of topical amiodadrone therapy before it can be widely integrated into current practice.
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Chen et al. (2022) conducted a systematic review in Postoperative atrial fibrillation following cardiac surgery. Intraoperative topical amiodarone was evaluated on Incidence of postoperative atrial fibrillation. A review of four studies found variable findings on the effect of intraoperative topical amiodarone therapy on the incidence of postoperative atrial fibrillation following cardiac surgery.
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