Document Detail

Diltiazem prophylaxis reduces incidence of atrial fibrillation after coronary artery bypass grafting.
MedLine Citation:
PMID:  16278634     Owner:  NLM     Status:  MEDLINE    
AIM: To evaluate the prophylactic effect of diltiazem on the incidence of atrial arrhythmia (fibrillation and/or flutter) following coronary artery bypass grafting (CABG). Data were retrospectively gathered. METHODS: Patients undergoing elective CABG by one surgeon at one institution over a three-year period were considered for inclusion. Those selected were divided into 3 groups: A (patients placed on intravenous diltiazem intraoperatively, then converted to oral diltiazem upon initiation of oral intake); B (patients started on oral diltiazem upon initiation of oral intake without prior intravenous diltiazem); and C (patients receiving no diltiazem). A comparison of postoperative rates of atrial fibrillation was made between the 3 (demographically balanced) groups using logistic regression. RESULTS: Two hundred and eighty seven patients met inclusion criteria. The incidence of postoperative atrial fibrillation in the entire sample was 19.9% (57/287). Incidence of postoperative atrial fibrillation within each group was: A = 16.3% (22/135); B = 12.7% (7/55); C = 28.9% (28/97). Statistical significance was demonstrated for the following comparisons: A versus C (p = 0.0451) and B versus C (p = 0.0065). In an alternate model groups A and B were combined and compared to C (p = 0.0181). CONCLUSIONS: A lower incidence of atrial fibrillation following CABG was observed in patients treated prophylactically with diltiazem. Differences were statistically significant whether the drug was administered intravenously and orally (A) or only orally (B). Diltiazem, which has an established role in the management of atrial fibrillation, may prove to be well suited for prophylaxis due to low cost and relative safety.
N Dobrilovic; L Vadlamani; B Buchert; C B Wright
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  46     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-11-09     Completed Date:  2006-01-19     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  457-61     Citation Subset:  IM    
Department of Surgery, The Jewish Hospital, Cincinnati, OH 45236, USA.
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MeSH Terms
Administration, Oral
Aged, 80 and over
Atrial Fibrillation / epidemiology,  etiology,  prevention & control*
Atrial Flutter / epidemiology,  etiology,  prevention & control*
Cardiovascular Agents / administration & dosage*
Coronary Artery Bypass / adverse effects*
Diltiazem / administration & dosage*
Infusions, Intravenous
Intraoperative Care
Middle Aged
Postoperative Care
Retrospective Studies
Reg. No./Substance:
0/Cardiovascular Agents; 42399-41-7/Diltiazem

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