Verapamil as prophylactic treatment for atrial fibrillation after lung operations.
BACKGROUND
Atrial fibrillation is a frequently occurring arrhythmia after thoracic operations. Preventive strategies for this complication have been extensively evaluated after cardiac operations.


METHODS
We performed a prospective, open randomized study, comparing intravenous verapamil and placebo in 199 patients after pneumonectomy or lobectomy at the University Hospital of Leuven. Verapamil was administered as a bolus of 10 mg over 2 minutes followed by a 30-minute infusion of 0.375 mg/min and then 0.125 mg/min for 3 days. The patients were continuously monitored in the postoperative intensive care unit.


RESULTS
Atrial fibrillation occurred in 15% of the patients receiving placebo and in 8% of the patients receiving verapamil (difference not significant). The verapamil infusion was interrupted in 9% of the patients because of bradycardia and in 14% because of hypotension.


CONCLUSIONS
If tolerated, continuous intravenous verapamil infusion showed only a modest prophylactic efficacy for the occurrence of atrial fibrillation after lung operations. In the dose employed the verapamil infusion was accompanied with a high incidence of side effects necessitating interruption of the therapy.
Van Mieghem
W
W
Department of Pulmonary Medicine, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium.
Tits
G
G
Demuynck
K
K
Lacquet
L
L
Deneffe
G
G
Tjandra-Maga
T
T
Demedts
M
M
D000638:Amiodarone / Q000009:adverse effects / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D001919:Bradycardia / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000453:epidemiology; D015994:Incidence; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000139:chemically induced / Q000453:epidemiology; D014700:Verapamil / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*
D000889:Anti-Arrhythmia Agents; D014700:Verapamil; D000638:Amiodarone