Does prophylactic sotalol and magnesium decrease the incidence of atrial fibrillation following coronary artery bypass surgery: a propensity-matched analysis.
BACKGROUND
Atrial fibrillation can occur in up to 40% of patients undergoing coronary surgery.


METHODS
We retrospectively analysed 103 consecutive coronary surgery patients under the care of one surgeon between April 2003 and September 2003. These patients received 40 mg of sotalol orally twice daily from the first post-operative day for 6 weeks and 2 g of magnesium intravenously immediately post surgery and on the first post-operative day. We developed a propensity score for the probability of receiving sotalol and magnesium after coronary surgery. 89 patients from the sotalol and magnesium group were successfully matched with 89 unique coronary surgery patients who did not receive either sotalol or magnesium with an identical propensity score.


RESULTS
Preoperative characteristics were well matched between groups. There was no significant difference with respect to in-hospital mortality between groups (sotalol and magnesium 1.1% versus control 4.5%; p = 0.17). The incidence of atrial fibrillation in the sotalol and magnesium group was 13.5% compared to 27.0% in the controls (p = 0.025).


CONCLUSIONS
The combination of sotalol and magnesium can significantly reduce the incidence of post-operative atrial fibrillation following coronary surgery.
Aerra
V
V
Department of Cardiothoracic Surgery, The Cardiothoracic Centre Liverpool, UK. vikram.aerra@gmail.com
Kuduvalli
M
M
Moloto
A N
AN
Srinivasan
A K
AK
Grayson
A D
AD
Fabri
B M
BM
Oo
A Y
AY
D000284:Administration, Oral; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D018890:Chemoprevention; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D013015:Sotalol / Q000008:administration & dosage*; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D008278:Magnesium Sulfate; D013015:Sotalol