Document Detail

The efficacy of sotalol in preventing postoperative atrial fibrillation: a meta-analysis.
MedLine Citation:
PMID:  21854895     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: Supraventricular tachyarrhythmias including atrial fibrillation are common and troubling complications after cardiac surgery, and thus considerable interest in pharmacologic prophylaxis has developed. The aim of this study was to evaluate the efficacy of sotalol in the prevention of postoperative supraventricular tachyarrhythmias.
METHODS: Standard methods of meta-analysis were used. Randomized clinical trials published in English language were eligible for the meta-analysis.
RESULTS: A systematic review revealed 15 eligible publications that provided 20 comparisons of sotalol with a control group. The incidence and relative risk (RR) with 95% confidence interval (CI) of developing postoperative supraventricular tachyarrhythmias while taking sotalol were sotalol (n=489) versus placebo (n=499): 22.5% versus 41.5%, RR=0.55 (CI, 0.454-0.667, P<.001); sotalol (n=304) versus no treatment (n=311): 12% versus 39%, RR=0.329 (CI, 0.236-0.459, P<.001); sotalol (n=488) versus beta-blocker (n=555): 14% versus 23%, RR=0.644 (CI, 0.495-0.838, P<.001); sotalol (n=139) versus amiodarone (n=146): no significant differences in supraventricular tachyarrhythmia prevention; and sotalol (n=51) versus magnesium (n=54): no significant differences in supraventricular tachyarrhythmia prevention. Initiating sotalol orally or intravenously had no significant effect on efficacy. Initiating sotalol after surgery showed a trend toward less adverse events (before: RR=1.700 [CI, 0.903-3.200] and after: RR=0.767 [CI, 0.391-1.505]).
CONCLUSION: Sotalol is more effective in the prevention of supraventricular tachyarrhythmia than placebo or beta-blockers. Initiating sotalol before cardiac surgery has no advantage compared with initiating sotalol shortly after surgery. Starting sotalol intravenously after surgery may be a more reliable method than administering via a nasogastric tube or delaying treatment until the patient can take oral medication.
Nicholas Z Kerin; Sony Jacob
Related Documents :
23644895 - The influence of steroid administration on systemic response in laminoplasty for cervic...
11490815 - Long-term follow-up of interferon-treated chronic hepatitis c and serum hepatic fibrosi...
19474745 - Peginterferon alpha-2b and ribavirin for the treatment of chronic hepatitis c in japane...
23752305 - Prospective assessment of lymphedema incidence and lymphedema-associated symptoms follo...
12438985 - Patient-based outcomes analysis of patients with single torsion thoracolumbar-lumbar sc...
18494195 - The advantages of end-to-side arteriovenous anastomosis over the other two types of art...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of medicine     Volume:  124     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  875.e1-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Medicine, Section of Cardiology, Wayne State University Medical School, Detroit, Mich.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  A Prospective Observational Study of Physician Handoff for Intensive-Care-Unit-to-Ward Patient Trans...
Next Document:  Barriers to non-HDL cholesterol goal attainment by providers.