328 * RANDOMIZED CONTROLLED TRIAL OF LOW-DOSE AMIODARONE FOR PREVENTION OF POSTOPERATIVE ATRIAL FIBRILLATION

Abstract

Objectives: Postoperative atrial fibrillation occurs in 20% to 40% of patients after coronary artery bypass grafting (CABG) and is associated with prolongation of hospitalization and increase in the risk of adverse events. The aim of this study was to test whether low-dose oral amiodarone would prevent atrial fibrillation and decrease hospital stay after CABG. Methods: Three-hundred and twenty-nine patients undergoing CABG were included in this prospective, randomized, double-blind and placebo controlled study. Patients were given 600 mg of amiodarone (n = 119) or placebo (n = 211) on the night before and on the morning of surgery, followed by 200 mg of amiodarone or placebo three times daily for the first five postoperative days. The endpoints were atrial fibrillation occurrence and hospital stay after CABG. Results: Postoperative atrial fibrillation occurred in four of the 119 patients in the amiodarone group (3.4%) versus 27 of the 210 patients in the placebo group (87%), P = 0.005. Patients in the amiodarone group were hospitalized for significantly fewer days than were patients in the placebo group (5.95 ± 4.2 vs 7.1 ± 2.4 days, P = 0.002). Postoperative complications occurred in 18 amiodarone- treated patients (15%) and in 36 patients receiving placebo (17.1%, P = 0.63). No differences were noted in baseline variables or mortality. Conclusions: Low-dose oral amiodarone is safe and effective in reducing the incidence of atrial fibrillation after CABG and significantly reduces the duration of hospitalization.