title: Amiodarone is a cost-neutral way of preventing atrial fibrillation after surgery for lung cancer.
abstract: OBJECTIVE
  Our aim was to estimate the costs and health benefits of routinely administered postoperative amiodarone as a prophylactic agent in reducing the risk of atrial fibrillation in patients undergoing surgery for lung cancer.
  
  
  METHODS
  This was a cost-effectiveness study, based on the randomized, controlled, double-blinded PASCART study, using avoidance of atrial fibrillation as the measure of benefit. Two hundred and fifty-four eligible, consecutively enrolled patients, undergoing surgery for lung cancer at the department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Denmark, were included and randomized to receive either 300 mg of amiodarone or placebo (5% aqueous dextrose solution), administered intravenously over 20 min immediately after surgery, followed by 600 mg of amiodarone/placebo orally twice per day (8 a.m. and 6 p.m.) for the first five postoperative days.
  
  
  RESULTS
  In the amiodarone group there were 11 cases of atrial fibrillation, compared with 38 in the control group (P < 0.001). There were no differences in the length of hospital stay or resources used. The mean total costs per patient were equal and amounted to €7288 per patient (P = 0.23). There were no signs of adverse developments referable to amiodarone in this prophylactic regime.
  
  
  CONCLUSIONS
  For patients undergoing surgery for lung cancer, routine use of postoperative prophylactic intravenous bolus and five subsequent days of oral amiodarone therapy reduces the risk of atrial fibrillation in a cost-neutral manner.
authors: Department of Cardiothoracic and Vascular Surgery & Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Lars P
authors: LP
authors: Riber
authors: Thomas D
authors: TD
authors: Christensen
authors: Hans K
authors: HK
authors: Pilegaard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000517:prevention & control*; D003718:Denmark; D005260:Female; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D011446:Prospective Studies
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone
keywords: Atrial fibrillation; Pharmacology (cardiovascular); Postoperative care; Statistics (clinical trial); Surgery for lung cancer