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Ann Thorac Surg 2003;75:2008
© 2003 The Society of Thoracic Surgeons

Correspondence

A simplified amiodarone regimen to prevent postoperative atrial fibrillation

Morris H. Drucker, MDa, Ian Smith, MDa

a 905 Pamplico Highway, Suite A315, Florence, SC 29505, USA

To the Editor:

We read with great interest the article written by White and associates [1] regarding two different amiodarone regimes and have also been concerned about reducing the incidence of postoperative atrial fibrillation. Based initially on an abstract presented at the STS meeting in 1999 by Drs Katariya, DeMarchena, and Bolooki [2], we adopted a rather simplified technique, which has been very efficacious in preventing atrial fibrillation in all patients requiring cardiopulmonary bypass and all "off pump" cases. Atrial fibrillation was defined as new onset atrial fibrillation/atrial flutter requiring treatment of greater than 1-minute duration. The patient received the first dose of amiodarone 600 mg per the nasogastric tube either in the operating room or upon arrival in the intensive care unit. Thereafter, the patient received amiodarone 200 mg TID for 5 days or until discharge. The amiodarone protocol also allowed for concomitant use of beta-blockers and did not exacerbate bradyarrhythmias. (Table 1)


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  		Table 1. Results of Amiodarone Therapy

 
These data demonstrate that a simplified standardized oral amiodarone regimen administered in the postoperative period can significantly reduce the incidence of atrial fibrillation without adverse sequalae and without adversely impacting concomitant medication. The addition of amiodarone did not result in an increase in bradydysrhythmias and we did not find any change in the number of patients requiring pacing. Also, there we did not detect any significant adverse outcomes as a consequence of the protocol.

References

  1. White C.M., Giri S., Tsikouris J.P., et al. Comparison of two individual amiodarone regimens to placebo in open heart surgery patients. Ann Thorac Surg 2002;74:69-74.[Abstract/Free Full Text]
  2. Katariya K., DeMarchena E., Bolooki H. Oral amiodarone reduces the incidence of postoperative atrial fibrillation. AnnThorac Surg 1999;74:1599-1603.




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