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Ann Thorac Surg 2000;70:157-161
© 2000 The Society of Thoracic Surgeons

Original articles: Cardiovascular

Intravenous amiodarone for prevention of atrial fibrillation after coronary artery bypass grafting

Shih-Huang Lee, MDa, Che-Ming Chang, MDa, Ming-Jen Lu, MDb, Ren-Jen Leea, Jun-Jack Cheng, MDa, Chi-Ren Hung, MDb, Shih-Ann Chen, MDa,b

a Divisions of Cardiology and Cardiovascular Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
b National Yang-Ming University, Taipei, Taiwan

Address reprint requests to Dr Shih-Huang Lee, Division of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, 95 Wen Chang Rd, Shih Lin, Taipei, Taiwan
e-mail: ufae0061{at}ms7.hinet.net

Background. Atrial fibrillation occurs in 10% to 40% of patients who undergo coronary artery bypass grafting. This prospective study assesses the safety and efficacy of low-dose intravenous amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting.

Methods. One hundred forty patients were randomly divided into two groups: an amiodarone group (n = 74) receiving intravenous amiadarone in a loading dose of 150 mg and maintenance dose of 0.4 mg · kg-1 · h-1 for 3 days before and 5 days after operation and a control group (n = 76) receiving matching infusions of 5% glucose solution.

Results. Atrial fibrillation occurred in 9 (12%) of the amiodarone group patients and in 26 (34%) of the control group patients during hospitalization (p < 0.01). The maximum ventricular rate during atrial fibrillation was significantly slower in the amiodarone group (107 ± 21) than in the control group (138 ±24 beats per minute, p < 0.01). The duration of atrial fibrillation in the amiodarone group (1.1 ± 1.2 hours) was significantly shorter than that in the control group (3.2 ± 1.3 hours, p = 0.01). The two groups had no significant differences in incidence of major morbidity (8 of 74 versus 8 of 76 in amiodarone and control groups, respectively) or mortality (4 of 74 versus 5 of 76). However, the control group had significantly longer intensive care unit stays (132 ± 24 versus 111 ± 19 hours, p < 0.01).

Conclusions. Perioperative low-dose intravenous amiodarone significantly reduces the incidence, ventricular rate, and duration of atrial fibrillation after coronary artery bypass grafting. Furthermore, low-dose intravenous amiodarone is well tolerated and does not increase the risk of intraoperative or postoperative complications.




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