| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2004;77:838-843
© 2004 The Society of Thoracic Surgeons
a Division of Coronary Care Unit, Valencia, Spain
b Division of Cardiovascular Surgery, Clinic University Hospital, Valencia, Spain
Accepted for publication May 6, 2003.
* Address reprint requests to Dr Sanjuán, Unitat Coronaria, Hospital Clínic Universitari, Av Blasco Ibáñez 17, 46010, Valencia, Spain.
e-mail: sanjuan_raf{at}gva.es
BACKGROUND: Atrial fibrillation is one of the most common complications of cardiac surgery. Beta blockers have been demonstrated to decrease the incidence of postoperative atrial fibrillation. Preliminary investigations reporting sotalol and atenolol to be effective in preventing postoperative atrial fibrillation are encouraging, but no studies have been conducted comparing both drugs.
METHODS: A total of 253 consecutive eligible patients (66 ± 8 years; mean ± standard deviation) scheduled to undergo cardiac surgery were enrolled in this study. Patients were randomized in a prospective open manner 1.5:1 to atenolol group (50 mg/daily; 153 patients) or sotalol group (80 mg twice daily; 100 patients).
RESULTS: Atrial fibrillation occurred in 44/253 patients (17.45%). A significant difference was found in the occurrence of atrial fibrillation in the atenolol group (34 patients, 22%) compared with those receiving sotalol (10 patients, 10%; p = 0.013). Therapeutic efficiency and efficacy was 12% and 54%, respectively. Stepwise logistic regression analysis revealed that age more than 68 years old (odds ratio = 2.72; 95% confidence interval [CI] = 1.37–5.41; p = 0.004), the use of ß-adrenergic agents (odds ratio = 2.74; 95% CI = 1.5–5; p = 0.001), and sotalol (odds ratio = 0.46; 95% CI = 0.23–0.95; p = 0.035) were independently associated with development of atrial fibrillation.
CONCLUSIONS: Oral low-dose sotalol provides a considerable reduction in the occurrence of atrial fibrillation. A selective approach based on clinical risk prediction should decrease the occurrence of atrial fibrillation after cardiac surgery.
This article has been cited by other articles:
|
|
 |
|
  J. Dunning, T. Treasure, M. Versteegh, S. A.M. Nashef, and on behalf of the EACTS Audit and Guidelines Commit Guidelines on the prevention and management of de novo atrial fibrillation after cardiac and thoracic surgery Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 852 - 872. [Full Text] [PDF]
|
|
|
|
 |
|
 D. C. Burgess, M. J. Kilborn, and A. C. Keech Interventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis Eur. Heart J., December 1, 2006; 27(23): 2846 - 2857. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Dunning and P. McKeown Are the american college of chest physicians guidelines for the prevention and management of atrial fibrillation after cardiac surgery already obsolete? Chest, April 1, 2006; 129(4): 1112 - 1113. [Full Text] [PDF]
|
|
|
|
 |
|
 R. H. Jones The Year in Cardiovascular Surgery J. Am. Coll. Cardiol., May 3, 2005; 45(9): 1517 - 1528. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Patel and J. Dunning Is Sotalol more effective than standard beta-blockers for the prophylaxis of atrial fibrillation during cardiac surgery Interactive CardioVascular and Thoracic Surgery, April 1, 2005; 4(2): 147 - 150. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
