title: Effects of amiodarone and thoracic epidural analgesia on atrial fibrillation after coronary artery bypass grafting.
abstract: OBJECTIVE
  This study was designed to assess the effects of a perioperative dosing regimen of amiodarone administration, high thoracic epidural anesthesia (TEA), or a combination of the 2 regimens on atrial fibrillation (AF) after coronary artery bypass grafting (CABG).
  
  
  METHODS
  The study was prospective, controlled, and randomized and was performed in a tertiary health care center associated with a university.
  
  
  METHODS
  One hundred sixty-three patients scheduled for coronary artery bypass graft surgery.
  
  
  METHODS
  In this 2 x 2 factorial-designed study the patients were randomized to 1 of 4 regimens in which group E had perioperative TEA, group E+A had TEA and amiodarone, group A had amiodarone, and group C served as control. The epidural catheter was inserted at T1-3 the day before surgery. TEA groups received TEA for 96 hours. The amiodarone regimen consisted of a single loading dose of 1,800 mg of amiodarone orally. Intravenous infusion of amiodarone was started after induction of anesthesia and was administered at 900 mg over 24 hours for the subsequent 3 days.
  
  
  RESULTS
  AF was documented using Holter monitoring. In group E 22 of 44 (50%), in group E+A 10 of 35 (28.6%), in group A 10 of 36 (27.8%), and in the control group 20 of 48 (41.7%) patients developed AF (odds ratio amiodarone/nonamiodarone 0.47 [0.24-0.90]; P = 0.02).
  
  
  CONCLUSIONS
  The perioperative amiodarone regimen used in this study was effective in reducing the incidence of AF after CABG while TEA was not.
authors.affiliation: Department of Cardiothoracic Anesthesia, National University Hospital, Rigshopitalet, Copenhagen, Denmark. einy@gentoftehosp.kbhamt.dk
authors.forename: Eigil
authors.initials: E
authors.lastname: Nygård
authors.forename: Lars H
authors.initials: LH
authors.lastname: Sørensen
authors.forename: Lamia B
authors.initials: LB
authors.lastname: Hviid
authors.forename: Finn M
authors.initials: FM
authors.lastname: Pedersen
authors.forename: Jesper
authors.initials: J
authors.lastname: Ravn
authors.forename: Lars
authors.initials: L
authors.lastname: Thomassen
authors.forename: Jesper H
authors.initials: JH
authors.lastname: Svendsen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Eliasen
authors.forename: Kim
authors.initials: K
authors.lastname: Krogsgaard
authors.forename: Jan
authors.initials: J
authors.lastname: Aldershvile
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage / Q000627:therapeutic use*; D015360:Analgesia, Epidural / Q000379:methods*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D015716:Electrocardiography, Ambulatory / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone