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Levosimendan use decreases atrial fibrillation in patients after coronary artery bypass grafting: a pilot study

Ahmet Feyzi Abacilar, Omer Faruk Dogan

    The Heart Surgery Forum
    |December 25, 2013
    PubMed

    Insights

    Levosimendan significantly reduced the incidence and duration of postoperative atrial fibrillation (AF) in patients undergoing coronary artery bypass grafting (CABG) with poor left ventricle function. This finding highlights levosimendan as a potential prophylactic agent for AF in high-risk cardiac surgery patients.

    Area of Science:

    • Cardiac Surgery
    • Cardiology
    • Pharmacology

    Background:

    • Postoperative atrial fibrillation (AF) is a common complication following coronary artery bypass grafting (CABG).
    • AF after CABG increases morbidity and mortality, particularly in patients with impaired left ventricle function.
    • Identifying effective prophylactic strategies for AF in this high-risk population is crucial.

    Purpose of the Study:

    • To evaluate the efficacy of levosimendan in preventing AF after CABG.
    • To assess the impact of levosimendan on AF incidence and duration in patients with poor left ventricle function.

    Main Methods:

    • A prospective, randomized, placebo-controlled trial involving 200 patients undergoing elective CABG.
    • Patients were randomized to receive either levosimendan (n=100) or placebo (n=100) intravenously.
    • Biomarkers including high-sensitivity C-reactive protein, cardiac troponin, and creatine kinase–MB were measured preoperatively and postoperatively.

    Main Results:

    • The incidence of AF was significantly lower in the levosimendan group (12%) compared to the placebo group (36%) (P < 0.05).
    • The duration of AF episodes was significantly shorter in patients treated with levosimendan (4.83 ± 1.12 hours) versus placebo (6.50 ± 1.55 hours) (P = 0.028).
    • Postoperative C-reactive protein levels were elevated in the control group compared to the levosimendan group (P < 0.05).

    Conclusions:

    • Levosimendan significantly reduces the incidence of postoperative atrial fibrillation in patients with poor left ventricle function undergoing CABG.
    • Levosimendan also shortens the duration of AF episodes in this patient cohort.
    • The findings suggest levosimendan is a promising agent for AF prophylaxis in high-risk CABG patients.
    Abstract

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