Postoperative intravenous amiodarone followed by oral amiodarone significantly reduced the incidence of new-onset atrial fibrillation compared to placebo (11.8% vs 26.5%) after off-pump coronary artery bypass grafting.
RCT (n=144)
Placebo-controlled
Randomized
Absolute Event Rate: 11.8% vs 26.5%
p-value: p=0.025
BACKGROUND: Atrial fibrillation is still a frequent complication that increases morbidity after coronary artery bypass grafting. This prospective randomized study is designed to define efficacy of postoperative amiodarone prophylaxis in preventing atrial fibrillation after off-pump coronary artery bypass grafting. METHODS: One hundred forty-four patients who underwent elective off-pump coronary artery bypass grafting were enrolled for the study. Seventy-six patients (amiodarone group) received 5 mg/kg loading amiodarone infusion in the first postoperative hour, followed by 10 mg/kg for the first 24 hours. After 24 hours, patients received 600 mg/day amiodarone orally for 7 days and 200 mg/day until the end of the postoperative first month. Sixty-eight patients received placebo (control group). RESULTS: Preoperative characteristics and operative variables of the patients were similar in both groups. Incidence of new-onset atrial fibrillation and maximal ventricular rate response were recorded. The incidence of new-onset atrial fibrillation (11.8% versus 26.5%) (P = .025) and maximal ventricular rate response (109 +/- 13.8 beats/min versus 124.5 +/- 13.9 beats/min) (P = .011) were significantly lower in the amiodarone group. Duration of atrial fibrillation was 17.5 +/- 8.1 hours for the amiodarone group compared with 32.7 +/- 12 hours for the control group (P = .002). CONCLUSION: Postoperative intravenous amiodarone prophylaxis followed by oral amiodarone significantly reduces the incidence of atrial fibrillation after off-pump coronary artery bypass grafting and the ventricular rate during atrial fibrillation.
Türk et al. (Tue,) conducted a rct in Patients undergoing elective off-pump coronary artery bypass grafting (OPCAB) (n=144). Amiodarone vs. Placebo (5% glucose IV for 24 hours, then standard medication) was evaluated on Incidence of new-onset atrial fibrillation (p=0.025). Postoperative intravenous amiodarone followed by oral amiodarone significantly reduced the incidence of new-onset atrial fibrillation compared to placebo (11.8% vs 26.5%) after off-pump coronary artery bypass grafting.
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