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AMIODARONE REDUCES RISK OF ATRIAL FIBRILATION AFTER OPEN-HEART SURGERY (p 830)
March 15, 2001The drug amiodarone when taken orally in combination with ß-blockers is effective in preventing atrial fibrillation, conclude authors of a study in this week's issue of THE LANCET.
Postoperative atrial fibrillation (AF - the most common form of sustained irregular heartbeat due to uncoordinated impulses in the small pumping chambers of the heart) occurs in 27-40% of open-heart surgery patients. ß-blockers and amiodarone reduce the frequency of AF after open-heart surgery, but the effectiveness of oral amiodarone in older patients already receiving ß-blockers is unknown. Satyendra Giri and colleagues from Hertford Hospital, Connecticut, USA, assessed the efficacy of oral amiodarone in preventing AF in patients aged 60 years or older undergoing open-heart surgery.
220 patients undergoing open-heart surgery (average age 73 years) received either amiodarone (120 patients) or placebo (100 patients). Patients on amiodarone had a lower frequency of AF (22.5% compared with 38%). Other improvements included: symptomatic atrial fibrillation (4.2% compared with 18%), stroke (1.7% compared with 7%), and postoperative ventricular tachycardia (increased heartbeat; 1.7% compared with 7%).
Jeffrey Kluger (one of the investigators) comments: "Atrial fibrillation is a common complication of open-heart surgery, especially in elderly people. Our study highlights the safety and efficacy of oral amiodarone in preventing atrial fibrillation in this population. An unexpected finding of the study was that amiodarone prophylaxis appears to also reduce the risk of stroke in elderly patients undergoing cardiac surgery. Our amiodarone treatment regimen is practical and has wide applicability to open-heart surgery patients". (Quote by e-mail; does not appear in published article).
Contact: Dr Jeffrey Kluger, Arrhythmia Service, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102-5037, USA; T) +1 860 545 2883; F) +1 860 545 2756; E) jkluger@harthosp.org
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