Intraoperative amiodarone as prophylaxis against atrial fibrillation after coronary operations

Interventions on Prevention of Postoperative Atrial Fibrillation in Patients Undergoing Heart Surgery

“…11,24,25 In trials published after 1995, the proportion of patients undergoing ␤-blocker therapy preoperatively was 61% to 80%. 12,13,33 The timing of initiation of study treatment varied between the trials, starting before, 9,10,18,19,25,38,39,41,43,45,48,49 during, 44 or after 6,11-17,20 -24,26 surgery. In 2 trials, 16,31 the intervention drug was administered at the end of ICU stay.…”

“…There were 9 trials [42][43][44][45][46][47][48][49][50] that evaluated the use of amiodarone, including 1384 patients (Figure 3). Individual study size ranged from 77 to 300 46,47 patients.…”

“…Sotalol did not significantly shorten of LOS (Ϫ0.40 days; 95% CI, Ϫ0.87 to 0.08). There were 5 amiodarone trials [43][44][45][46]48 (944 patients enrolled, 68% of all patients randomized in amiodarone trials) that reported the effect on the LOS. Amiodarone reduced LOS significantly by 0.91 days (95% CI, Ϫ1.59 to Ϫ0.24) ( Figure 5).…”

“…The incidence of postoperative stroke was available for 14 of 52 trials. 9,13,28,33,37,[41][42][43][44][45][46]48,54,59 These trials represented data for 2877 of a total of 8122 patients randomized (35%). In these studies, the percentage of patients with AF was reduced from 38.6% in the control group to 23.7% in the treatment group (OR, 0.38; 95% CI, 0.28 to 0.52), which is similar to the overall estimate.…”

Alta dose de amiodarona em curto período reduz incidência de fibrilação atrial e flutter atrial no pós-operatório de cirurgia de revascularização miocárdica

“…Many prophylactic methods for the reduction of supraventricular arrhythmias, especially AF, have been investigated with promising results 3 . The prophylactic use of amiodarone has shown to be effective in minimizing the incidence of AF 1,[4][5][6][7][8][9][10] . However, the lack of a consensus regarding the homogenous dose, period of treatment and administration route observed among the clinical studies makes it difficult to utilize amiodarone as a prophylactic method.…”