Abstract

IRIGOIN, JAVIER et al. Amiodarona como profilaxis de la fibrilación auricular en el postoperatorio de cirugía cardíaca. Rev.Urug.Cardiol. [online]. 2008, vol.23, n.2, pp.134-141. ISSN 1688-0420.

SUMMARY Atrial fibrillation (AF) is the most frequent arrhythmia in the post-operative period of cardiac surgery. It generates morbidity and increases hospital length of stay and costs. Multiple randomized trials have shown the efficacy of amiodarone in the prophylaxis of AF. In our institution, a postoperative AF prophylaxis protocol with intravenous amiodarone is taking place. Aims: to analyze the feasibility of this protocol in the regular clinical practice, one year after it started. Methods: from October 2006 to September 2007, all patients who underwent open heart surgery were considered. Prophylaxis was started in 67% (183/272) of eligible patients. Intravenous amiodarone was started in the first 24 hours with a target dose of at least 1 g. Cumulative incidence of AF was calculated for patients with and without prophylaxis. Length of stay was calculated for the same groups of patients and for those with and without AF. Results: median of follow-up was 32 days; the protocol had to be interrupted in 27% (49/183) of patients. Cumulative incidence of AF was 28% (77/272) in the eligible population. Cumulative incidence of AF was lower in patients who received amiodarone. Length of stay was significantly shorter in patients treated with amiodarone and in those without AF. Conclusions: prophylaxis protocol was feasible in  two thirds of patients undergoing open heart surgery, but it was completed in half of them. The incidence of AF persists high in eligible patients. Patients who received amiodarone had fewer incidence of AF and shorter length of stay.

Keywords :     AMIODARONE;     ATRIAL FIBRILLATION; CARDIAC SURGERY.

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