Oral amiodarone reduces incidence of postoperative atrial fibrillation.
BACKGROUND
Atrial fibrillation (AF) is a common occurrence after heart operations that use cardiopulmonary bypass. It can cause life-threatening complications as well as delay discharge and increase hospitalization costs. The purpose of this study was to evaluate the effect of orally administered low-dose amiodarone on the incidence of new onset postoperative AF.


METHODS
In this prospective study, 226 consecutive adult patients (group A) who had various heart operations utilizing cardiopulmonary bypass between April and November of 1998 at the University of Miami/Jackson Memorial Hospital, were given oral amiodarone (200 mg three times a day), starting immediately after arrival in the intensive care unit until the day of hospital discharge. The incidence of new AF in this group of patients was assessed and compared with a historical group of 239 patients (group B) who had had cardiac operations with cardiopulmonary bypass in the preceding 9 months at the same institution.


RESULTS
Preoperative patient characteristics and procedure types were similar in the two groups. Among the 226 patients in group A, 13 (5.7%) had history of AF. Of the remaining 213 patients, new-onset AF occurred postoperatively in 10 (4.7%). Among the 239 patients in group B, 16 (6.7%) had history of AF. Of the remaining 223 patients, 44 (19.7%) developed new-onset AF (p < 0.001). Group A patients had a shorter length of hospital stay than those in group B (6.5 versus 7.8 days) but had a similar incidence of complications other than AF (23 of 226 patients in group A versus 24 of 239 in group B). The drug was well tolerated.


CONCLUSIONS
Postoperative low-dose amiodarone given orally to patients who had cardiopulmonary bypass was well tolerated and appeared to reduce the incidence of new-onset AF and decrease the length of hospital stay.
Katariya
K
K
Division of Cardiothoracic Surgery, University of Miami School of Medicine, Florida 33101, USA.
DeMarchena
E
E
Bolooki
H
H
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage* / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D002315:Cardiopulmonary Bypass; D003422:Critical Care; D004305:Dose-Response Relationship, Drug; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012008:Recurrence
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone