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March 3, 2006Journal of Cardiothoracic SurgeryOpen Access

Does prophylactic sotalol and magnesium decrease the incidence of atrial fibrillation following coronary artery bypass surgery: a propensity-matched analysis

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Why the study?

Does prophylactic sotalol and magnesium reduce the incidence of atrial fibrillation following coronary surgery?

Population

178 propensity-matched patients undergoing coronary surgery (89 per group)

Comparison

Sotalol 40 mg orally twice daily for 6 weeks… vs No sotalol or magnesium

Design

Cohort

Follow-up

in-hospital / 6 weeks

Authors

VAVikram AerraEssex Cardiothoracic CentreMKManoj KuduvalliUniversity of LiverpoolAMAN MolotoEssex Cardiothoracic Centre

Discussion

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Implication

Sotalol plus magnesium was associated with lower post-CABG AF; leaves open whether routine prophylaxis is warranted pending randomized trials.

Key Points

  • To evaluate whether prophylactic administration of oral sotalol combined with intravenous magnesium reduces post-operative atrial fibrillation in patients undergoing coronary artery bypass surgery.
  • Analyzed 103 consecutive coronary surgery patients treated with oral sotalol (40 mg twice daily for 6 weeks starting on post-operative day 1) and intravenous magnesium (2 g immediately post-op and on post-operative day 1).
  • Applied propensity score matching to compare 89 treated patients with 89 matched control patients who did not receive sotalol or magnesium.
  • The incidence of post-operative atrial fibrillation was significantly lower in the sotalol and magnesium group at 13.5% compared to 27.0% in the control group (p = 0.025).
  • In-hospital mortality did not differ significantly between the sotalol and magnesium group (1.1%) and the control group (4.5%, p = 0.17).

Structured PICO

Does prophylactic sotalol and magnesium reduce the incidence of atrial fibrillation following coronary surgery?

P
Population
178 propensity-matched patients undergoing coronary surgery (89 per group)
I
Intervention
Sotalol 40 mg orally twice daily for 6 weeks starting post-operative day 1, plus magnesium 2 g intravenously immediately post surgery and on post-operative day 1
C
Comparator
No sotalol or magnesium (propensity-matched controls)
O
Outcome
Incidence of atrial fibrillationhard clinical

Prophylactic administration of sotalol and magnesium significantly reduces the incidence of post-operative atrial fibrillation following coronary surgery.

Cite This Study

Aerra et al. (2006) studied this question.

synapsesocial.com/papers/6a852f724edd3eca19cf22b4https://doi.org/10.1186/1749-8090-1-6

Topics

Persistent AF managementAtrial fibrillationAnticoagulation in AF
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