TY - JOUR
T1 - Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection
AU - Lanza, Louis A.
AU - Visbal, Antonio I.
AU - DeValeria, Patrick A.
AU - Zinsmeister, Alan R.
AU - Diehl, Nancy N.
AU - Trastek, Victor F.
AU - Kohman, Leslie J.
AU - Weder, Walter
PY - 2003/1/1
Y1 - 2003/1/1
N2 - 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.
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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U2 - 10.1016/S0003-4975(02)04285-6
DO - 10.1016/S0003-4975(02)04285-6
M3 - Article
C2 - 12537220
AN - SCOPUS:0037232583
SN - 0003-4975
VL - 75
SP - 223
EP - 230
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 1
ER -