Atrial fibrillation (AF) affects up to 50% of post-operative cardiac surgery patients. AF is rarely fatal and most cases are transient and clinically benign. AF however could occasionally lead to many serious complications such as thromboembolic strokes, ischemic bowel, hypotension, or hemorrhage secondary to the required anticoagulation therapy. In addition, hospital length of stay is often prolonged due to the need to control this arrhythmia prior to discharge. Many strategies to prevent the onset of this condition have been the subject of intense research in recent years. Many pharmacologic and non-pharmacologic agents have been studied with varying degrees of success. Amiodarone, a very effective class III anti-arrhythmic agent, has been shown to reduce the onset of this condition by half in this patient population. Most Amiodarone studies were conducted on coronary artery bypass grafting (CABG) patients and the uptake of this intervention strategy by clinicians has been poor at best. The purpose of this study was to examine the possible benefit of using Amiodarone in a select group of cardiac surgery patients who were deemed to be at a higher risk of developing post-operative AF using a randomized controlled trial model. This select group of patients included valve patients, patients with poor left ventricular function, and the elderly. In addition, the possible economic benefit of such selective prophylactic strategy was evaluated. No clear clinical or economic benefits were demonstrated at the conclusion of the trial. The required a priori sample size was not achieved at the conclusion of the trial and hence many of the results did not achieve statistical significance.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/27691 |
| Date | January 2008 |
| Creators | Haddad, Michel |
| Publisher | University of Ottawa (Canada) |
| Source Sets | Université d’Ottawa |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 116 p. |
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