Document Detail

Amiodarone versus a beta-blocker to prevent atrial fibrillation after cardiovascular surgery.
MedLine Citation:
PMID:  11685167     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Both amiodarone and beta-blockers have been shown to decrease the incidence of atrial fibrillation after cardiovascular surgery. However, the superior agent has not been identified. METHODS: We performed a pilot study on 102 patients (68 men, mean age 65 +/- 10 years, mean left ventricular ejection fraction 0.53 +/- 0.12) undergoing cardiovascular surgery (94 coronary artery bypass grafting [CABG], 5 valvular surgery only, and 3 CABG + valvular surgery). The patients were randomized to receive amiodarone (1 g/d intravenously x 48 hours, then 400 mg/d orally until discharge) or propranolol (1 mg intravenously every 6 hours x 48 hours, then 20 mg orally four times a day until discharge). Atrial fibrillation was defined as lasting longer than 1 hour or resulting in hemodynamic compromise. RESULTS: The incidence of postoperative atrial fibrillation was 16.0% (8/50) in the amiodarone group and 32.7% (17/52) in the propranolol group (P =.05). The mean length of stay was 8.8 +/- 3.5 days for amiodarone-treated patients and 8.4 +/- 2.7 days for propranolol-treated patients (P not significant). Serious adverse events were uncommon and similar in each group. CONCLUSION: Early intravenous amiodarone, followed by oral amiodarone, appears to be superior to propranolol in the prevention of postoperative atrial fibrillation. It is well tolerated and can be started at the time of surgery. However, the use of amiodarone did not result in a reduction in the length of hospital stay.
A J Solomon; M D Greenberg; M J Kilborn; N M Katz
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  142     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-10-30     Completed Date:  2002-01-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  811-5     Citation Subset:  AIM; IM    
Division of Cardiology, Department of Medicine, Georgetown University, Medical Center, Washington, DC 20007, USA.
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MeSH Terms
Amiodarone / therapeutic use*
Atrial Fibrillation / prevention & control*
Coronary Artery Bypass
Coronary Disease / surgery*
Heart Valves / surgery*
Middle Aged
Pilot Projects
Postoperative Complications / prevention & control*
Propranolol / therapeutic use*
Reg. No./Substance:
1951-25-3/Amiodarone; 525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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