Amiodarone versus digoxin and metoprolol combination for the prevention of postcoronary bypass atrial fibrillation.
OBJECTIVE
This prospective randomized study aims at evaluation and comparison of the prophylactic effects of amiodarone versus digoxin and metoprolol combination in postcoronary bypass atrial fibrillation.


METHODS
A total of 241 consecutive patients undergoing elective coronary artery bypass grafting were randomly allocated into three groups. Patients in Group1 (n=77) received metoprolol 100 mg/24 h per oral (P.O.), preoperatively, 2x0.5 mg digoxin intravenously on the operating day and digoxin 0.25 mg P.O.+metoprolol 100 mg P.O. on the first postoperative day until discharge. Patients in Group 2 (n=72) received totally 1200 mg intravenous/24 h amiodarone which the 300 mg - bolus dose/1 h was given as soon as the operation had been finished. On the next day patients were administered 450 mg/24 h amiodarone i.v. and 600 mg/day in three doses P.O. were given until discharge. Group 3 (n=92) was the control group with no antiarrhythmic prophylaxis.


RESULTS
Preoperative patient characteristics and operative parameters were similar in three groups. Atrial fibrillation occurred in 13 patients (16.8%) in Group 1, six patients (8.3%) in Group 2 and 31 patients (33.6%) in Group 3.


CONCLUSIONS
Both study groups were effective in the prevention of postcoronary bypass atrial fibrillation with respect to control (P<0.01 in Group 1 and P<0.001 in Group 2).
Tokmakoglu
Hilmi
H
Department of Thoracic and Cardiovascular Surgery, Bayindir Hospital, 5. cad. No: 15/5 Bahcelievler, Ankara 06500, Turkey. tokmakoglu@isnet.net.tr
Kandemir
Ozer
O
Gunaydin
Serdar
S
Catav
Zeki
Z
Yorgancioglu
Cem
C
Zorlutuna
Yaman
Y
D000638:Amiodarone / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000517:prevention & control*; D001026:Coronary Artery Bypass; D004077:Digoxin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies
D000889:Anti-Arrhythmia Agents; D004077:Digoxin; D008790:Metoprolol; D000638:Amiodarone