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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Amiodarone cost effectiveness in preventing atrial fibrillation after coronary artery bypass graft surgery

Lars R Zebis1, Thomas D Christensen, Ivar S Kristiansen

  • 1Department of Cardiothoracic and Vascular Surgery, and Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Denmark. lrz@post.tele.dk

The Annals of Thoracic Surgery
|December 25, 2007
PubMed

Insights

Routine postoperative amiodarone significantly reduced atrial fibrillation after coronary artery bypass grafting (CABG), lowering care costs by €175 per patient. This prevention strategy offers both clinical and economic benefits.

Area of Science:

  • Cardiology
  • Pharmacoeconomics
  • Clinical Trials

Background:

  • Atrial fibrillation is a common complication after coronary artery bypass grafting (CABG).
  • Preventive strategies for postoperative atrial fibrillation are crucial for improving patient outcomes and reducing healthcare costs.

Purpose of the Study:

  • To estimate the costs and health benefits of routine postoperative amiodarone for preventing atrial fibrillation in CABG patients.
  • To evaluate the cost-effectiveness of amiodarone prophylaxis in the context of stable angina surgery.

Main Methods:

  • A randomized, controlled, double-blind trial (RASCABG study) was conducted.
  • 250 CABG patients received either intravenous/oral amiodarone or placebo for 5 days post-surgery.
  • Benefit was measured by the avoidance of atrial fibrillation.

Main Results:

  • Amiodarone significantly reduced atrial fibrillation incidence (14 vs. 32 cases, p < 0.01).
  • No significant difference in length of hospital stay was observed between groups.
  • Mean total cost per patient was €7,639 for amiodarone vs. €7,814 for placebo (p < 0.01).

Conclusions:

  • Routine postoperative amiodarone effectively reduces the risk of atrial fibrillation post-CABG.
  • Amiodarone therapy resulted in a cost saving of €175 per patient.
  • The findings support the routine use of amiodarone for atrial fibrillation prevention in CABG patients.
Abstract

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