Key result
The prophylactic use of amiodarone combined with vitamin C significantly reduced the incidence of postoperative atrial fibrillation to 9.2% compared to 13.1% with amiodarone alone after coronary artery bypass grafting.
Why the study?
Postoperative AF increases mortality and morbidity after CABG, prompting evaluation of whether combining the antioxidant and anti-inflammatory properties of vitamin C with amiodarone improves prophylaxis over amiodarone alone.
Does the combination of amiodarone and vitamin C reduce the incidence of postoperative atrial fibrillation in patients undergoing CABG compared to amiodarone alone?
RCT (n=84)
Double-blind
Cubalrandomized method
No
Does the combination of amiodarone and vitamin C reduce the incidence of postoperative atrial fibrillation in patients undergoing CABG compared to amiodarone alone?
Absolute Event Rate: 9.2% vs 13.1%
p-value: p=0.01
The prophylactic combination of amiodarone and vitamin C significantly reduces the incidence of postoperative atrial fibrillation and other arrhythmias following CABG compared to amiodarone alone.
May support adjunctive vitamin C with amiodarone to lower POAF after CABG; leaves open confirmation in larger trials.
Atrial fibrillation (AF) is the most common arrhythmia following cardiac surgery, leading to hemodynamic impairment and increased mortality and morbidity after coronary artery bypass grafting (CABG) and increases hospitalization. Due to the antioxidant and anti-inflammatory effects of vitamin C as well as the antiarrhythmic effect of amiodarone in reducing the incidence of atrial fibrillation after coronary artery bypass grafting, we decided to compare and evaluate the prophylactic effect of amiodarone alone and in combination with vitamin C in controlling this complication. In this double-blind clinical trial, patients were divided into two equal groups of amiodarone (300 mg amiodarone bolus during 20-30 minutes) and amiodarone + vitamin C (150 mg amiodarone and 2g vitamin C combination). Each group included 42 patients. All data were analyzed by SPSS 19 software and statistical tests of ANOVA, Chi-square and Repeated Measure. There was a significant difference between the two groups of amiodarone and amiodarone+vitamin C (p-value = 0.01) and the mean incidence of AF in the amiodarone +vitamin C group was significantly lower than that of amiodarone alone. Other arrhythmias were also lower in the amiodarone +vitamin C group than in the amiodarone group alone. The use offibrillation after CABG compared with prophylactic amiodarone alone, but did not have a significant effect on decreasing ICU stay(discharge) and duration of hospitalization.
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Kamali et al. (2021) conducted an RCT in Atrial fibrillation after coronary artery bypass grafting (n=84). Amiodarone and Vitamin C vs. Amiodarone alone (300 mg bolus, followed by amiodarone infusion and normal saline over 24 hours) was evaluated on Incidence of postoperative atrial fibrillation (p=0.01). The prophylactic use of amiodarone combined with vitamin C significantly reduced the incidence of postoperative atrial fibrillation to 9.2% compared to 13.1% with amiodarone alone after coronary artery bypass grafting.
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