Medication reduces risk of heart irregularities after cardiac surgery

t/repair surgery, and patients who received preoperative beta-blocker therapy with those who did not.

The study included 601 patients who had CABG surgery and/or valve replacement/repair surgery between February 1, 1999, and September 26, 2003. The patients were followed up for 1 year. Patients received oral amiodarone or placebo, administered 6 days prior to surgery through 6 days after surgery (total of 13 days).

Amiodarone was associated with a halving of the overall incidence of atrial tachyarrhythmias lasting 5 minutes or longer.

Postoperative sustained ventricular tachyarrhythmias occurred less frequently in amiodarone patients (1/299; 0.3 percent) than in placebo patients (8/302; 2.6 percent). There were no differences in serious postoperative complications, in-hospital mortality, or readmission to the hospital within 6 months of discharge or in 1-year mortality.

"The number needed to treat [with amiodarone] to prevent 1 patient from developing postoperative atrial tachyarrhythmia was only 7.5 overall and was even lower in older patients, in patients having valve surgery, and in patients not receiving concomitant beta-blocker therapy," the authors write.

"The PAPABEAR trial demonstrates that a 13-day perioperative course of oral amiodarone is an effective, possibly safe, well-tolerated, and widely applicable therapy for the prevention of postoperative atrial tachyarrhythmia after cardiac surgery. This benefit was associated with a reduction in the probability of perioperative sustained ventricular tachyarrhythmia and a trend toward a reduction in postoperative hospital stay," the researchers conclude.

(JAMA.2005; 294:3093-3100. Available pre-embargo to the media at www.jamamedia.org)


Contact: Colleen Donahue
JAMA and Archives Journals

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