Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection.
BACKGROUND
Atrial fibrillation after pulmonary resection increases morbidity and costs. To evaluate the efficacy of low-dose oral amiodarone (LDOA) as prophylaxis for atrial fibrillation after pulmonary resection, we reviewed all patients 60 years or older having pulmonary resections by thoracotomy in a 30-month period.


METHODS
We identified 31 patients who received prophylactic LDOA (200 mg by mouth every 8 hours) while hospitalized and 52 patients who received no prophylactic treatment. The groups were comparable for sex, age, comorbidities, and surgical procedure.


RESULTS
Twenty of 83 patients (24%) had postoperative atrial fibrillation: 17 of 52 patients (33%) without prophylaxis and 3 of 31 (9.7%) with prophylaxis (odds ratio, 0.221; 95% confidence interval, 0.059 to 0.829; p = 0.0253). The median total hospital charge was $30,800 (range, $20,400-$96,900) for 50 patients without prophylaxis and $26,700 (range, $11,000-$55,900) for 31 patients with prophylaxis (p = not significant). Patients receiving LDOA had lower accumulated charges per day of hospital stay (p = 0.0011).


CONCLUSIONS
LDOA prophylaxis significantly reduces the incidence of atrial fibrillation after pulmonary resection. Its use in this population may be cost-effective. Results of this pilot study provide a rationale for a prospective randomized trial.
Lanza
Louis A
LA
Division of Cardiovascular and Thoracic Surgery, Mayo Clinic, Scottsdale, Arizona, USA.
Visbal
Antonio I
AI
DeValeria
Patrick A
PA
Zinsmeister
Alan R
AR
Diehl
Nancy N
NN
Trastek
Victor F
VF
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000517:prevention & control*; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000517:prevention & control
D000638:Amiodarone