Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection

Louis A. Lanza, Antonio I. Visbal, Patrick A. DeValeria, Alan R. Zinsmeister, Nancy N. Diehl, Victor F. Trastek, Leslie J. Kohman, Walter Weder

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Background. Atrial fibrillation after pulmonary resection increases morbidity and costs. To evaluate the efficacy of low-dose oral amiodarone (LDOA) as prophylaxis for atrial fibrillation after pulmonary resection, we reviewed all patients 60 years or older having pulmonary resections by thoracotomy in a 30-month period. Methods. We identified 31 patients who received prophylactic LDOA (200 mg by mouth every 8 hours) while hospitalized and 52 patients who received no prophylactic treatment. The groups were comparable for sex, age, comorbidities, and surgical procedure. Results. Twenty of 83 patients (24%) had postoperative atrial fibrillation: 17 of 52 patients (33%) without prophylaxis and 3 of 31 (9.7%) with prophylaxis (odds ratio, 0.221; 95% confidence interval, 0.059 to 0.829; p = 0.0253). The median total hospital charge was $30,800 (range, $20,400-$96,900) for 50 patients without prophylaxis and $26,700 (range, $11,000-$55,900) for 31 patients with prophylaxis (p = not significant). Patients receiving LDOA had lower accumulated charges per day of hospital stay (p = 0.0011). Conclusions. LDOA prophylaxis significantly reduces the incidence of atrial fibrillation after pulmonary resection. Its use in this population may be cost-effective. Results of this pilot study provide a rationale for a prospective randomized trial.

Original languageEnglish (US)
Pages (from-to)223-230
Number of pages8
JournalAnnals of Thoracic Surgery
Volume75
Issue number1
DOIs
StatePublished - Jan 1 2003

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Amiodarone
Atrial Fibrillation
Lung
Hospital Charges
Costs and Cost Analysis
Thoracotomy
Mouth
Comorbidity
Length of Stay
Odds Ratio
Confidence Intervals
Morbidity
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Lanza, L. A., Visbal, A. I., DeValeria, P. A., Zinsmeister, A. R., Diehl, N. N., Trastek, V. F., ... Weder, W. (2003). Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection. Annals of Thoracic Surgery, 75(1), 223-230. https://doi.org/10.1016/S0003-4975(02)04285-6

Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection. / Lanza, Louis A.; Visbal, Antonio I.; DeValeria, Patrick A.; Zinsmeister, Alan R.; Diehl, Nancy N.; Trastek, Victor F.; Kohman, Leslie J.; Weder, Walter.

In: Annals of Thoracic Surgery, Vol. 75, No. 1, 01.01.2003, p. 223-230.

Research output: Contribution to journalArticle

Lanza, LA, Visbal, AI, DeValeria, PA, Zinsmeister, AR, Diehl, NN, Trastek, VF, Kohman, LJ & Weder, W 2003, 'Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection', Annals of Thoracic Surgery, vol. 75, no. 1, pp. 223-230. https://doi.org/10.1016/S0003-4975(02)04285-6
Lanza LA, Visbal AI, DeValeria PA, Zinsmeister AR, Diehl NN, Trastek VF et al. Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection. Annals of Thoracic Surgery. 2003 Jan 1;75(1):223-230. https://doi.org/10.1016/S0003-4975(02)04285-6
Lanza, Louis A. ; Visbal, Antonio I. ; DeValeria, Patrick A. ; Zinsmeister, Alan R. ; Diehl, Nancy N. ; Trastek, Victor F. ; Kohman, Leslie J. ; Weder, Walter. / Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection. In: Annals of Thoracic Surgery. 2003 ; Vol. 75, No. 1. pp. 223-230.
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AU - Diehl, Nancy N.

AU - Trastek, Victor F.

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AB - Background. Atrial fibrillation after pulmonary resection increases morbidity and costs. To evaluate the efficacy of low-dose oral amiodarone (LDOA) as prophylaxis for atrial fibrillation after pulmonary resection, we reviewed all patients 60 years or older having pulmonary resections by thoracotomy in a 30-month period. Methods. We identified 31 patients who received prophylactic LDOA (200 mg by mouth every 8 hours) while hospitalized and 52 patients who received no prophylactic treatment. The groups were comparable for sex, age, comorbidities, and surgical procedure. Results. Twenty of 83 patients (24%) had postoperative atrial fibrillation: 17 of 52 patients (33%) without prophylaxis and 3 of 31 (9.7%) with prophylaxis (odds ratio, 0.221; 95% confidence interval, 0.059 to 0.829; p = 0.0253). The median total hospital charge was $30,800 (range, $20,400-$96,900) for 50 patients without prophylaxis and $26,700 (range, $11,000-$55,900) for 31 patients with prophylaxis (p = not significant). Patients receiving LDOA had lower accumulated charges per day of hospital stay (p = 0.0011). Conclusions. LDOA prophylaxis significantly reduces the incidence of atrial fibrillation after pulmonary resection. Its use in this population may be cost-effective. Results of this pilot study provide a rationale for a prospective randomized trial.

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