Effects of diltiazem prophylaxis on the incidence and clinical outcome of atrial arrhythmias after thoracic surgery

Amar, David; Roistacher, Nancy; Rusch, Valerie W.; Leung, Denis H. Y.; Ginsburg, Ilana; Zhang, Hao; Bains, Manjit S.; Downey, Robert J.; Korst, Robert J.; Ginsberg, Robert J.

doi:10.1067/mtc.2000.109538

Cited by 134 publications

(69 citation statements)

References 38 publications

(71 reference statements)

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“…Calciumchannel blockers such as verapamil and diltiazem have been shown to have no effect in reducing arrhythmias after noncardiac surgery and our study suggests the same (14% versus 11.5%, p = 0.76) [22,23]. An interesting hypothesis that statins or NSAIDs might decrease inflammation and hence contribute to decreased atrial fibrillation has been propagated but our study did not find a similar association [24].…”

Section: Discussioncontrasting

confidence: 57%

Does laparoscopic surgery decrease the risk of atrial fibrillation after foregut surgery?

et al. 2008

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Section: Discussioncontrasting

confidence: 57%

Does laparoscopic surgery decrease the risk of atrial fibrillation after foregut surgery?

et al. 2008

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“…In our study, we found no statistically signifi cant diff erence between patient groups with and without diltiazem prophylaxis, suggesting that in our patients, POAF occurred as a complication of lung resection comparably often with and without diltiazem prophylaxis. So, we could not confi rm the report by Amar et al on diltiazem therapy and its signifi cant POAF rate reduction 3 . Our speculation that patients with diltiazem prophylaxis generally have somewhat slower ventricular response during POAF (median 150; without any prophylaxis, median 160), which could have some protective properties per se, was not confi rmed by statistical analysis.…”

Section: Discussioncontrasting

confidence: 49%

“…Lobectomies and pneumonectomies are recognized as high risk procedures with POAF incidence above 15% 1 . Among drugs recommended for the prophylaxis of POAF and equivalent postoperative arrhythmias is diltiazem, a calcium antagonist 2,3 . It has few side eff ects and, with respect to known contraindications, it is well tolerated, especially in patients with chronic obstructive pulmonary disease (COPD) 2 .…”

Section: Introductionmentioning

confidence: 99%

Postoperative Atrial Fibrillation Prophylaxis and Lung Resection – Our Experience with 608 Consecutive Patients

Karadža

Stančić-Rokotov

Macan

et al. 2017

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SUMMARY -Postoperative atrial fi brillation is a common complication after lung resection. It is burdened by increased mortality and morbidity, prolonged hospitalization, and higher resource utilization in thoracic surgery patients. Th erefore, some kind of pharmacological prophylaxis is recommended. In our patients, diltiazem, a calcium antagonist, is administered. We collected data on all 608 patients having undergone lung resection (no less than lobectomy) between November 2012 and May 2015. Th is period included patients having received diltiazem during their postoperative stay in our Intensive Care Unit and surgical ward, and those that did not receive it. Patients having had atrial fi brillation before the surgery and patients with cardiac pacemaker were excluded from the trial. Other patients were divided into three groups: patients with some kind of antiarrhythmic therapy before and continued after the surgery; patients with diltiazem prophylaxis; and patients without any antiarrhythmic prophylaxis. Th e data collected were statistically analyzed. We found no statistically signifi cant diff erence in the incidence of postoperative atrial fi brillation among the groups (p<0.05).

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“…Arrhythmia was also one of the main causes of death in patients with lung cancer during postoperative period, and it directly affected the postoperative recovery (21,22). It could be seen that the occurrence of arrhythmia after lung cancer surgery was influenced by a variety of factors, such as preoperative ECG abnormalities, advanced ages, and hypertension, operation modes.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the risk factors of postoperative cardiopulmonary complications and ability to predicate the risk in patients after lung cancer surgery

Gao

et al. 2017

J. Thorac. Dis.

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Background: Postoperative cardiopulmonary complications might be fatal for patients with lung cancer after surgery. The aim of this study was to identify the risk factors of postoperative cardiopulmonary complications in lung cancer patients and get a fitting formula for predicting incidences of cardiopulmonary complications. Methods:We conducted a retrospective analysis of 653 patients with a diagnosis of lung cancer who underwent a surgery in the Tianjin Medical University Cancer Institute and Hospital (Tianjin, China) from January to December 2014. All patients received lung cancer surgeries. Clinical data was collected for the analysis of the influence factors of cardiopulmonary complication after lung cancer surgeries. The medical statistical analysis program R was used to calculate cardiopulmonary complication probability of classification of quantitative results.Results: Our work showed that ages, lymphocyte count, smoking history, chronic bronchitis history, operation mode and extubation time were significantly associated with lung infection both in univariate and multivariate survival analysis. And ages, smoking history, arrhythmia of electrocardiogram and operation mode were significantly associated with postoperative arrhythmia both in univariate and multivariate survival analysis. Multiple linear regressions were generated with risk factors by program R software. Finally, we got a fitting formula for predicting cardiopulmonary complications. Risk score for each patient could be obtained by this formula. Conclusions:The incidences of pulmonary infection and arrhythmia were high for patients who underwent lung cancer surgery. It is important to discriminate risk factors for each patient for reducing the risk of heart and lung complications. Preoperative quantitative evaluation of cardiopulmonary complication after operation is beneficial to the risk control.

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Effects of diltiazem prophylaxis on the incidence and clinical outcome of atrial arrhythmias after thoracic surgery

Abstract: After major thoracic operations, prophylactic diltiazem reduced the incidence of clinically significant atrial arrhythmias in patients considered at high risk for this complication.

Cited by 134 publications

References 38 publications

Does laparoscopic surgery decrease the risk of atrial fibrillation after foregut surgery?

Does laparoscopic surgery decrease the risk of atrial fibrillation after foregut surgery?

Postoperative Atrial Fibrillation Prophylaxis and Lung Resection – Our Experience with 608 Consecutive Patients

Analysis of the risk factors of postoperative cardiopulmonary complications and ability to predicate the risk in patients after lung cancer surgery

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