Abstract 3250: Low-does Of Amiodarone For The Prevention Of Atrial Fibrillation After Coronary Artery Bypass Grafting
Aim: to identify the risk factors associated with atrial fibrillation after CABG and to evaluate the necessity, anti-arrhythmic efficacy and safty of low-does of amiodarone for AF.
Methods: Between April 2005 and April 2007, 480 adult patients underwent CABG were randomly divided into two groups. They were given 0.6 g of amiodarone (220 cases) or placebo (260 cases) daily in 7 days before surgery and 0.2 g of amiodarone or placebo daily for 30 days postoperatively. Electrocardiograms were monitored over 14-day postoperative period.
Results : Of 480 patients, there were 85 patients(17.7%) occurred AF. The recurrent AF usually developed within 1–3 days after operation, and continued for 0.5–24 hours. The incidence of postoperative AF was significantly (p < 0.001) lower in patients on low-does of amiodarone (9.55%) as compared with placebo (24.62%). Heart rate at onset of atrial fibrillation were 131.4 ± 28.9 beats/min for amiodarone compared with 144.1 ± 30.7 for placebo (P < 0.05). Duration of AF were 12.8 ± 6.7 hours in amiodarone group compared with 18.2 ± 11.6 hours in placebo group(P < 0.05).
Conclusion: The strongest independent preoperative predictors for AF after CABG were the patients’age(≥ 70 ys), heart failure(EF ≤ 40% and/or FS ≤ 24%) and hypokalemia; Postoperative administration of Low-does of amiodarone reduced the occurrence of AF by 27.97% and prevented sudden death by 17.02% after CABG surgery; Amiodarone is the safest in four groups of anti-arrhythmic drugs, Preventive trials of low does of amiodarone significantly reduces the incidence, ventricular rate, and duration of AF after CABG, and seems to be of similar efficacy with the trials of large does amiodarone. Furthermore, low-dose amiodarone is well tolerated and decreases the risks of severe side effects and proarrhythmic effects, especially for these patients with high risk factors at peroperative period.