Amiodarone prophylaxis for atrial fibrillation of high-risk patients after coronary bypass grafting: a prospective, double-blinded, placebo-controlled, randomized study

Budeus, Marco; Hennersdorf, M.; Perings, Stefan; Röhlen, Shinga; Schnitzler, Stefan; Felix, Oliver; Reimert, Klaus; Feindt, P.; Gams, E.; Lehmann, Nils; Wieneke, Heinrich; Sack, Stefan; Erbel, Raimund; Perings, Christian

doi:10.1093/eurheartj/ehl082

Cited by 62 publications

(45 citation statements)

References 24 publications

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“…Some of them reported a reduced occurrence of AF,38–44 whereas others found no statistically significant differences 45–48. These differences in outcomes might be due to inconsistencies in dosing and administration strategies as some used intravenous amiodarone,38,40,48 others applied oral amiodarone,39,41,43,46,47 and still others used a combination of intravenous and oral amiodarone 42,44,45. However, out comes of prophylactic amiodarone use differed even within administration groups 38–48.…”

Section: Discussionmentioning

confidence: 99%

Comparison of posttransplant outcomes in patients with no, acute, or chronic amiodarone use before heart transplantation

Rivinius¹,

Helmschrott²,

Ruhparwar

et al. 2017

DDDT

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BackgroundMajor concerns about the safety of pretransplant amiodarone use have been raised. As a result of its long half-life, the cardiac allograft is exposed to amiodarone posing potential risks such as bradycardia, requirement for pacemaker implantation, or increased mortality after heart transplantation (HTX).ObjectiveThe aim of this study is to investigate the posttransplant outcomes of patients with no, acute, or chronic amiodarone use before HTX.MethodsThis retrospective single-center study included 530 adult patients who received HTX between 06/1989 and 12/2012. Patients were stratified by their amiodarone therapy before HTX: no continuous amiodarone use (≤90 days before HTX), acute amiodarone use (≤90 days before HTX), and chronic amiodarone use (>90 days before HTX). Differences between the 3 groups in demographics, posttransplant medication, echocardiographic features, heart rates including occurrences of bradycardia, permanent pacemaker implantation, atrial fibrillation (AF), and survival were analyzed.ResultsA total of 412 patients (77.7%) were in the “no amiodarone” group, 23 patients (4.4%) in the “acute amiodarone” group, and 95 patients (17.9%) in the “chronic amiodarone” group. Left ventricular ejection fraction (P=0.5819), heart rates including occurrence of bradycardia during posttransplant week 1 (P=0.0979 and P=0.2695), week 2 (P=0.1214 and P=0.8644), week 3 (P=0.1033 and P=0.8894), and week 4 (P=0.2892 and P=0.8644), permanent pacemaker implantation within 30-day (P=0.8644), or overall follow-up after HTX (P=0.8664) were not significant between groups. Patients with chronic pretransplant amiodarone therapy had the lowest rate of early posttransplant AF (P=0.0065). There was no statistically significant difference between groups in 30-day (P=0.8656), 1-year (P=1.0000), 2-year (P=0.8763), 5-year (P=0.5174), or overall posttransplant follow-up mortality (P=0.1936).ConclusionAdministration of acute or chronic pretransplant amiodarone was not related to an increased occurrence of bradycardia, requirement for permanent pacemaker implantation, or mortality after HTX. Importantly, chronic amiodarone use effectively reduced early AF after HTX, whereas acute amiodarone use showed no such effect.

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Section: Discussionmentioning

confidence: 99%

Comparison of posttransplant outcomes in patients with no, acute, or chronic amiodarone use before heart transplantation

Rivinius¹,

Helmschrott²,

Ruhparwar

et al. 2017

DDDT

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“…The development of AF is extremely common after cardiac surgery and is associated with longer intensive care unit and hospital stays, increased morbidity and mortality, and higher utilisation of healthcare resources [6][7][8][9][10][11]. For these reasons, it is of utmost importance to identify patients who are at risk for the development of postoperative AF (POAF), and to take due precautions in the preoperative period.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of HATCH score as a predictor of atrial fibrillation after coronary artery bypass graft

et al. 2016

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A b s t r a c tBackground: Atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery is associated with increased morbidity and mortality. The HATCH score was originally devised to predict the progression of paroxysmal AF to persistent AF. Aim:To determine whether the HATCH score predicts the development of AF after CABG surgery. Methods:The medical records of 284 consecutive patients, who underwent CABG surgery between January 2013 and December 2014, were retrospectively reviewed for the development of AF in the postoperative (POAF) period. The HATCH score, and clinical and echocardiographic parameters were evaluated for all patients.Results: Seventy (25%) patients developed POAF. The HATCH scores were higher in the POAF group (2.8 ± 1.8 vs. 1.1 ± 1.2, p < 0.001). The area of the HATCH score under the curve in the receiver operating characteristics analysis was 773 (95% CI 706-841, p < 0.001). When the HATCH score was 2 or more as a threshold, there was for POAF 72% sensitivity and 75% specificity. Conclusions:The results of the present study suggest that the HATCH score can be used to predict the development of POAF.

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“…Various studies regarding the causes of POAF have been conducted, including advanced age, obesity, left atrial dimensions, cardiac dysfunction, chronic respiratory failure, renal dysfunction, fluid balance, preoperative medications, inflammation, and fibrosis, but no definitive consensus has yet been reached and various factors are involved with the occurrence [1][2][3][4][5] (Fig. 1).…”

Section: Cause Of Atrial Fibrillation After Cardiac Surgerymentioning

confidence: 99%

“…Atrial fibrillation (AF) is the most common complication after cardiac surgery, with an incidence of 16%-85%. Postoperative AF (POAF) often occurs in the early period after surgery, [1][2][3] and has an influence on stroke and early postoperative cardiac events, as well as on the long-term prognosis. Thus, it is important to prevent POAF.…”

Section: Introductionmentioning

confidence: 99%

The Role of β-Blockers in Cardiac Perioperative Management

Sezai

Shiono

2014

Ann Thorac Cardiovasc Surg

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Amiodarone prophylaxis for atrial fibrillation of high-risk patients after coronary bypass grafting: a prospective, double-blinded, placebo-controlled, randomized study

Cited by 62 publications

References 24 publications

Comparison of posttransplant outcomes in patients with no, acute, or chronic amiodarone use before heart transplantation

Comparison of posttransplant outcomes in patients with no, acute, or chronic amiodarone use before heart transplantation

Usefulness of HATCH score as a predictor of atrial fibrillation after coronary artery bypass graft

The Role of β-Blockers in Cardiac Perioperative Management

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