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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Amiodarone versus a beta-blocker to prevent atrial fibrillation after cardiovascular surgery

A J Solomon1, M D Greenberg, M J Kilborn

  • 1Division of Cardiology, Department of Medicine, Georgetown University, Medical Center, Washington, DC 20007, USA. Solomona@gunet.georgeto2n.edu

American Heart Journal
|October 31, 2001
PubMed

Insights

Amiodarone significantly reduced postoperative atrial fibrillation after cardiovascular surgery compared to propranolol. While effective in preventing arrhythmias, amiodarone did not shorten hospital stays in this pilot study.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pharmacology

Background:

  • Atrial fibrillation is a common complication following cardiovascular surgery.
  • Both amiodarone and beta-blockers are used to prevent postoperative atrial fibrillation.
  • The comparative efficacy of amiodarone versus beta-blockers for this indication remains unclear.

Purpose of the Study:

  • To compare the efficacy of amiodarone and propranolol in preventing atrial fibrillation after cardiovascular surgery.
  • To evaluate the safety and tolerability of amiodarone and propranolol in this patient population.

Main Methods:

  • A pilot randomized controlled trial involving 102 patients undergoing cardiovascular surgery.
  • Patients received either intravenous/oral amiodarone or intravenous/oral propranolol.
  • Postoperative atrial fibrillation was defined as lasting longer than 1 hour or causing hemodynamic compromise.

Main Results:

  • The incidence of atrial fibrillation was 16.0% with amiodarone versus 32.7% with propranolol (P = .05).
  • Mean length of hospital stay was similar between groups (8.8 days vs. 8.4 days, P not significant).
  • Serious adverse events were infrequent and comparable between the amiodarone and propranolol groups.

Conclusions:

  • Early intravenous amiodarone followed by oral administration is superior to propranolol for preventing postoperative atrial fibrillation.
  • Amiodarone is well-tolerated and can be initiated perioperatively.
  • Amiodarone did not lead to a reduction in hospital length of stay.
Abstract

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