Abstract:
AIMS:Atrial fibrillation (AF) occurs often in patients after coronary artery bypass grafting (CABG) and can result in increased morbidity and mortality. Previous studies using P-wave signal-averaged electrocardiogram (P-SAECG) have shown that patients with a longer filtered P-wave duration (FPD) have a high risk of AF after CABG. We have shown that patients with an FPD > or = 124 ms and a root-mean-square voltage of the last 20 ms of the P-wave 20 < or = 3.7 microV have an increased risk of AF after surgery. Accordingly, the aim of this study was to investigate whether or not prophylactic peri-operative administration of amiodarone could reduce the incidence of AF in this high-risk group undergoing CABG identified by P-SAECG. METHODS AND RESULTS:In this prospective, double-blinded, placebo-controlled, randomized study, 110 patients received either amiodarone (n = 55) or placebo (n = 55). During CABG, two patients of both groups died. Amiodarone was given as 600 mg oral single dose one day before and from days 2 through 7 after surgery. In addition, amiodarone was also administered intravenously during surgery in a 300-mg bolus for 1 h and as a total maintenance dose of 20 mg/kg weight over 24 h on the first day following surgery. The primary endpoint was the occurrence of AF after CABG. The secondary endpoint was the hospitalization length of stay after CABG. The baseline characteristics were similar in both treatment groups. The incidence of post-operative AF was significantly higher in the placebo group compared with the amiodarone group (85 vs. 34% of patients, P < 0.0001). The prophylactic therapy with amiodarone significantly reduced the intensive care (1.8 +/- 1.7 vs. 2.4 +/- 1.5 days, P = 0.001) and hospitalization length of stay (11.3 +/- 3.4 vs. 13.0 +/- 4.3 days, P = 0.03). In the amiodarone group, concentrations of amiodarone and desethylamiodarone differed significantly between patients with AF and sinus rhythm (amiodarone: 0.96 +/- 0.5 vs. 0.62 +/- 0.4 microg/mL, P = 0.02; desethylamiodarone: 0.65 +/- 0.2 vs. 0.48 +/- 0.1 microg/mL, P = 0.04). CONCLUSION:The incidence of post-operative AF among high-risk patients was significantly reduced by a prophylactic amiodarone treatment resulting in a shorter time of intensive care unit and hospital stay. Our data supports the prophylactic use of amiodarone in peri-operative period in patients at high risk for AF after CABG.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Budeus M,Hennersdorf M,Perings S,Röhlen S,Schnitzler S,Felix O,Reimert K,Feindt P,Gams E,Lehmann N,Wieneke H,Sack S,Erbel R,Perings Cdoi
10.1093/eurheartj/ehl082subject
Has Abstractpub_date
2006-07-01 00:00:00pages
1584-91issue
13eissn
0195-668Xissn
1522-9645pii
ehl082journal_volume
27pub_type
杂志文章,随机对照试验abstract::The safety of calcium antagonists has recently become a controversial issue among cardiologists. Thus, the role of calcium antagonists in the treatment of myocardial infarction and in secondary cardiovascular prevention is under review. As a consequence, the concept that the words 'calcium antagonists' comprise variou...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/18.suppl_a.56
更新日期:1997-01-01 00:00:00
abstract:AIMS:Release of progenitor cells is observed during inflammatory conditions and contributes to neovascularization. We, therefore, sought to investigate the relationship of circulating progenitor cells and interleukin (IL)-8 in acute myocardial infarction (AMI). METHODS AND RESULTS:From patients with stable angina and ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi761
更新日期:2006-05-01 00:00:00
abstract:AIMS:To evaluate the prevalence, clinical significance, and prognosis of latent Brugada syndrome (BrS) in patients with new-onset atrial fibrillation (AF) unmasked by class 1C antiarrhythmic drugs. METHODS AND RESULTS:Between January 2000 and June 2008, all consecutive patients with new-onset AF, who after flecainide ...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehp326
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doi:10.1093/eurheartj/ehz925
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abstract:AIMS:The purpose of this study was to calculate the prevalence of ectopic atrial tachycardia in a population of young asymptomatic males and to assess its natural course both in asymptomatic subjects and in symptomatic hospital patients. METHODS AND RESULTS:12-lead electrocardiograms (ECG) of 3554 consecutive males ap...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1998.1313
更新日期:1999-05-01 00:00:00
abstract::A twenty-first century model for the training and assessment of cardiac interventionists’ skills, outlined by Prof. John Morgan FRCP FESC. ...
journal_title:European heart journal
pub_type: 杂志文章
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更新日期:2011-01-01 00:00:00
abstract::AIMS More intense platelet-directed therapy for acute coronary syndrome (ACS) may increase bleeding risk. The aim of the current analysis was to determine the rate, clinical impact, and predictors of major and fatal bleeding complications in the PLATO study. METHODS AND RESULTS PLATO was a randomized, double-blind, ac...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehr422
更新日期:2011-12-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a060769
更新日期:1995-11-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.1.129
更新日期:1993-01-01 00:00:00
abstract:AIMS:To estimate the incidence of dementia after the first atrial fibrillation (AF), and its impact on survival in a community-based cohort. METHODS AND RESULTS:Olmsted County, Minnesota adult residents diagnosed with first AF during 1986-2000 were identified, and followed until 2004. The primary outcome was new detec...
journal_title:European heart journal
pub_type: 杂志文章
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062518
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2004-07-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-08-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061429
更新日期:1983-02-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章
doi:10.1093/eurheartj/14.3.377
更新日期:1993-03-01 00:00:00
abstract::Streptococcus adjacens and S. defectivus are two recently individualized species of viridans streptococci. Both species were previously designated as nutritionally variant streptococci and characterized by their growth as small satellite colonies supported by 'helper' bacteria, or requiring complex media enriched with...
journal_title:European heart journal
pub_type: 杂志文章,评审
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更新日期:1995-04-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060386
更新日期:1994-01-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:1983-11-01 00:00:00
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pub_type: 新闻
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更新日期:2015-05-14 00:00:00
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doi:10.1093/eurheartj/ehq112
更新日期:2011-01-01 00:00:00
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更新日期:2014-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1053/euhj.2001.3081
更新日期:2002-08-01 00:00:00
abstract::Type 2 diabetes mellitus (T2DM) is characterized by multiple pathophysiologic abnormalities. With time, multiple glucose-lowering medications are commonly required to reduce and maintain plasma glucose concentrations within the normal range. Type 2 diabetes mellitus individuals also are at a very high risk for microva...
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pub_type: 杂志文章,评审
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更新日期:2015-09-07 00:00:00
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059805
更新日期:1990-09-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
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更新日期:2012-03-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060259
更新日期:1992-06-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
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更新日期:2013-06-01 00:00:00
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更新日期:2014-04-01 00:00:00