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J Thorac Cardiovasc Surg 2003;125:463-464
© 2003 The American Association for Thoracic Surgery

Editorials

Amiodarone in cardiothoracic surgery patients: What is a surgeon to do?

William L. Holman, MD

From the Department of Surgery, University of Alabama at Birmingham, Birmingham, Ala.

Received for publication June 24, 2002. Accepted for publication July 19, 2002. Address for reprints: William L. Holman, MD, the Department of Surgery, University of Alabama at Birmingham, 703 S 19th St, Room 719, Birmingham, AL 35294-0007.

The first 20% of the full text of this article appears below.

See related article on page 633.

In this issue of The Journal of Thoracic and Cardiovascular Surgery, the CAMIAT InvestigatorsGo 1 present an interesting post hoc analysis of amiodarone used in 82 patients undergoing cardiac surgery who were part of a larger trial that examined prophylactic amiodarone therapy in patients at risk for sudden death after myocardial infarction. This post hoc analysis has a problem common to all such analyses; namely the initial research proposal was not specifically designed or powered to answer the questions that were raised in the secondary analysis. Nevertheless, the small number of prospective trials (especially prospective randomized trials) of amiodarone used in the setting of cardiac surgery make this information useful for placing the risks of amiodarone into perspective with its benefits.

Crystal and associates found no differences in the 7- and 30-day mortalities, duration of intensive care unit stay, risk of atrial or ventricular fibrillation, and risk of pulmonary complications between those who did and did not receive amiodarone before a cardiac operation. However, there was a higher rate of postoperative intra-aortic balloon pump use among the patients treated with amiodarone. Thus this study supports the . . . [Full Text of this Article]


Related Article

Long-term amiodarone therapy and the risk of complications after cardiac surgery: Results from the Canadian Amiodarone Myocardial Infarction Arrhythmia Trial (CAMIAT)
Eugene Crystal, Shoshanah Kahn, Robin Roberts, Kevin Thorpe, Michael Gent, John A. Cairns, Paul Dorian, and Stuart J. Connolly
J. Thorac. Cardiovasc. Surg. 2003 125: 633-637. [Abstract] [Full Text] [PDF]





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