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Background: Atrial fibrillation (AF) occurs commonly after esophagectomy. Strategies for prophylaxis of post-esophagectomy AF have not been widely studied.
Purpose: To determine the efficacy and safety of intravenous (IV) amiodarone for the prevention of AF after esophagectomy.
Methods: In this retrospective cohort study, 254 patients undergoing esophagectomy were matched (1:1) using a propensity score including age ± 5 years, sex, surgical approach and history of chronic obstructive pulmonary disease. Subjects were divided into two groups: those who received prophylactic IV amiodarone (amiodarone group, AG, n=127) or no AF prophylaxis (propensity score-matched control group, CG, n=127). The AG received amiodarone 43.75mg/hour by continuous IV infusion over 96 hours (total dose: 4200 mg) initiated at the time of anesthesia induction.
Results: The incidence of AF was significantly lower in the AG than in the CG (Table). There were no significant differences between the AG and CG in median post-operative length of hospital stay or in the incidence of pulmonary complications or mortality. However, there was a significantly higher incidence of adverse effects in the AG, including hypotension requiring treatment, bradycardia and QT interval prolongation.
Conclusions: Prophylactic IV amiodarone reduces the incidence of AF following esophagectomy, but is associated with adverse effects including hypotension, bradycardia, and QT interval prolongation.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation and VT: Incorporating Novel Risks Toward Decision Making
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1280-107
- 2017 American College of Cardiology Foundation