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J Thorac Cardiovasc Surg 2003;125:633-637
© 2003 The American Association for Thoracic Surgery
Cardiopulmonary Support and Physiology |
From the Departments of Medicinea and Clinical Epidemiology and Biostatistics,b Faculty of Health Sciences, McMaster University, Hamilton, Ontario, the Department of Medicine, University of British Columbia, Vancouver, British Columbia,c and the Department of Medicine, University of Toronto, Toronto, Ontario,d Canada, and the Department of Cardiology, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel.e
Received for publication March 17, 2002. Revisions requested April 16, 2002; revisions received June 24, 2002. Accepted for publication Aug 6, 2002. Address for reprints: Eugene Crystal, MD, 237 Barton St E, Arrhythmia Service, Hamilton General Hospital, Hamilton, Ontario L8L 2X2, Canada (E-mail: crystal{at}bgumail.bgu.ac.il).
Objective: This study was undertaken to determine the association between amiodarone therapy and risk of complications of cardiac surgery in patients in the randomized placebo-controlled, double-blind Canadian Amiodarone Myocardial Infarction Arrhythmia Trial.
Methods: Prospectively collected data regarding postoperative complications in 82 patients who underwent cardiac surgery during Canadian Amiodarone Myocardial Infarction Arrhythmia Trial participation were analyzed; 36 patients were randomly assigned to receive amiodarone and 46 were assigned to receive placebo. Of the patients randomly assigned to receive amiodarone, 24 patients continued amiodarone treatment to within 7 days of the operation (active amiodarone group) and 12 patients had the amiodarone discontinued at least 7 days before the operation (discontinued amiodarone group).
Results: The baseline characteristics of the three groups were similar. The risks of ventricular fibrillation, atrial fibrillation, and respiratory complications were similar. The risk of requiring an intra-aortic balloon pump was significantly increased by amiodarone (34.8% vs 16.7% vs 8.7% for active amiodarone, discontinued amiodarone, and placebo groups, respectively, P = .024). There was no significant difference in the use of temporary pacing. Neither the mean duration of stay in the intensive care unit nor the 7- and 30-days mortalities were affected by amiodarone.
Conclusions: Patients receiving long-term amiodarone treatment after myocardial infarction had a higher rate of intra-aortic balloon use after cardiac surgery. There was no increased risk of pulmonary complications, need for pacing, or death.
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J. Thorac. Cardiovasc. Surg. 2003 125: 463-464.
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