High dose of amiodarone in a short-term period reduces the incidence of postoperative atrial fibrillation and atrial flutter

OBJECTIVE: To investigate wheter oral amiodarone administered before surgery for a short period in high dose would reduce the incidence of postoperative atrial fibrillation or atrial flutter and reduces the lenght of hospital stay. METHODS: In the double-blind, randomized study, 93 patients were given either oral amiodarone (46 patients) or placebo (47 patients). Therapy consisted of 600mg of amiodarone three times a day, started at mininum 30 hours and at maximum 56 hours before surgery. RESULTS: Postoperative atrial fibrillation or atrial flutter occurred in 8 of 46 patients in the amiodarone group (17.4%) and 19 of the 47 patients in the placebo group (40.4%) (p=0.027). The mean dose of amiodarone was 2.8g. Patients in the amiodarone group were hospitalized for 8.9±3.1 days and patients in the placebo group were hospitalized for 11.4± 8.7 days (p=0.07). The hospital lenght were significantly prolonged in patients who developed atrial arrhythmias after surgery, despite the treatment received.(p<0.001). CONCLUSION: This new alternative way of using amiodarone in high dose and in a short-term period before surgery reduce the incidence of postoperative atrial fibrillation or atrial flutter in coronary artery bypass graft surgery.