Key result
Varying durations of overlap when transitioning from IV to oral amiodarone were not significantly associated with AF recurrence within 24 hours (OR 1.00; 95% CI 1.00-1.01; P=0.9).
Why the study?
Although amiodarone is widely used for postoperative AF, data are lacking regarding the optimal duration of overlap when transitioning from intravenous to oral amiodarone.
Does the duration of overlap when transitioning from IV to oral amiodarone affect atrial fibrillation recurrence in cardiothoracic surgery patients?
Observational (n=184)
No
Does the duration of overlap when transitioning from IV to oral amiodarone affect atrial fibrillation recurrence in cardiothoracic surgery patients?
Odds Ratio: 1 (95% CI 1–1.01)
p-value: p=0.9
In cardiothoracic surgery patients, transitioning from IV to oral amiodarone can be done safely without a specific overlap duration, as overlap duration does not affect AF recurrence, bradycardia, or hypotension.
No association between overlap duration and AF recurrence in cohort data; leaves open optimal IV-to-oral amiodarone transition protocols.
The use of amiodarone for postoperative atrial fibrillation (AF) is widespread; however, there is a paucity of data on the optimal duration of overlap when transitioning from intravenous (IV) to oral amiodarone. The objective of this study was to evaluate the safety and efficacy of varying durations of overlap when amiodarone IV infusion is transitioned to oral administration in cardiothoracic surgery patients. This retrospective, observational, single-center study included cardiothoracic surgery patients who were initiated on IV amiodarone for supraventricular arrhythmia and subsequently transitioned to oral amiodarone. The primary outcome was AF recurrence within 24 hours after IV amiodarone discontinuation. Safety outcomes include occurrence of bradycardia or hypotension while on amiodarone. A total of 184 patients were included for analysis. AF recurrence occurred in 24.5% of patients (n = 45). No significant association was found between various overlap durations and AF recurrence (odds ratio (OR) 1.00, 95% CI 1.00-1.01, P = 0.9). In addition, no significant association was found between duration of overlap and rates of bradycardia (OR 1.00, 95% confidence interval (CI) 0.99-1.00, P = 0.08) or hypotension (OR 1.00, 95% CI 0.99-1.00, P = 0.21), which occurred in 35.9% and 47.3% of patients, respectively. Our study suggests following conversion to normal sinus rhythm; cardiothoracic surgery patients can effectively and safely be transitioned from IV to oral amiodarone without the need for specific overlap duration or transition strategy.
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A 2022 study conducted an observational in Postoperative atrial fibrillation (n=184). Duration of overlap when transitioning from IV to oral amiodarone was evaluated on Atrial fibrillation recurrence within 24 hours after IV amiodarone discontinuation (OR 1.00, 95% CI 1.00-1.01, p=0.9). Varying durations of overlap when transitioning from IV to oral amiodarone were not significantly associated with AF recurrence within 24 hours (OR 1.00; 95% CI 1.00-1.01; P=0.9).
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