title: Ability of amiodarone and propranolol alone or in combination to prevent post-coronary bypass atrial fibrillation.
abstract: Atrial fibrillation (AF) is the most common arrhythmia in coronary artery bypass grafting (CABG) patients. The purpose of this study was to determine the best prophylaxis for AF prior to CABG. In this double-blind randomized study, 240 consecutive patients underwent elective CABG. They were then divided randomly into three groups to receive propranolol (n = 80), amiodarone (n = 80), or both drugs (n = 80). All groups received their medications from preoperative day 7 to post-CABG day 5. The patients were well matched for age, sex, risk factors, comorbidities, ejection fraction, and cardioplegic technique. Post-CABG AF developed in 22 patients (9.2%) of whom 13 (16.3%) had received propranolol, 5 (6.3%) had received amiodarone, and 4 (5%) had received both drugs. The difference between the propranolol group and the other two groups was statistically significant (P= 0.02), but that between the amiodarone and amiodarone + propranolol group was not significant. Age was a significant predictor of post-CABG AF (P= 0.034). Other factors such as diabetes, sex, hyperlipidemia, smoking, hypertension, family history, cerebrovascular accidents, left atrial size, and ejection fraction were not significant predictors of post-CABG AF. Preoperative amiodarone or amiodarone with propranolol were more effective than propranolol in reducing the frequency of AF. There was a strong relationship between age and the development of AF. (Clinicaltrial.gov registration NCT00654290.).
authors.affiliation: Cardiology Department, Shiraz University of Medical Sciences, Shiraz, Iran. kojurij@yahoo.com
authors.forename: Javad
authors.initials: J
authors.lastname: Kojuri
authors.forename: Yadollah
authors.initials: Y
authors.lastname: Mahmoodi
authors.forename: Mansoor
authors.initials: M
authors.lastname: Jannati
authors.forename: Masih
authors.initials: M
authors.lastname: Shafa
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ghazinoor
authors.forename: Mahammad Bagher
authors.initials: MB
authors.lastname: Sharifkazemi
mesh_terms: D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011433:Propranolol / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D011433:Propranolol; D000638:Amiodarone