Is Sotalol more effective than standard beta-blockers for the prophylaxis of atrial fibrillation during cardiac surgery (original) (raw)
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Preoperative use of sotalol versus atenolol for atrial fibrillation after cardiac surgery
Annals of Thoracic Surgery, 2004
Background. Atrial fibrillation is one of the most common complications of cardiac surgery. Beta blockers have been demonstrated to decrease the incidence of postoperative atrial fibrillation. Preliminary investigations reporting sotalol and atenolol to be effective in preventing postoperative atrial fibrillation are encouraging, but no studies have been conducted comparing both drugs.
2020
Postoperative atrial fibrillation is a very common surgical complication encountered in patients undergoing Cardiac Surgery including Coronary Artery Bypass Grafting and Valvular Surgeries, which leads to increase hospital stay and burden on health care providers. The aim of this review study was to to determine the effectiveness of current management for the Prophylaxis of Postoperative Atrial Fibrillation in Cardiac Surgeries and to propose a possible prophylaxis to prevent POAF. 21 research papers were selected and brought under review after carefully considering the current day evidence for prophylaxis and each having its scientific evidence and background. The papers were carefully reviewed and findings were given in favour of Amiodarone, Ascorbate and B-Blockers including Sotalol. This can rightly be concluded from this study that prophylaxis with Ascorbate for 5 days prior to cardiac surgery along with the use of Amiodarone 1.2 g before surgery and 600 mg/day till 3rd post op...
Pharmacologic prophylaxis for atrial fibrillation following cardiac surgery: a systematic review
Journal of Cardiothoracic Surgery, 2010
Atrial Fibrillation (AF) is the most common arrhythmia occurring after cardiac surgery. Its incidence varies depending on type of surgery. Postoperative AF may cause hemodynamic deterioration, predispose to stroke and increase mortality. Effective treatment for prophylaxis of postoperative AF is vital as reduces hospitalization and overall morbidity. Βeta -blockers, have been proved to prevent effectively atrial fibrillation following cardiac surgery and should be routinely used if there are no contraindications. Sotalol may be more effective than standard b-blockers for the prevention of AF without causing an excess of side effects. Amiodarone is useful when beta-blocker therapy is not possible or as additional prophylaxis in high risk patients. Other agents such as magnesium, calcium channels blocker or non-antiarrhythmic drugs as glycoseinsulin -potassium, non-steroidal anti-inflammatory drugs, corticosteroids, N-acetylcysteine and statins have been studied as alternative treatment for postoperative AF prophylaxis.
Journal of Cardiothoracic Surgery, 2006
Background Atrial fibrillation can occur in up to 40% of patients undergoing coronary surgery. Methods We retrospectively analysed 103 consecutive coronary surgery patients under the care of one surgeon between April 2003 and September 2003. These patients received 40 mg of sotalol orally twice daily from the first post-operative day for 6 weeks and 2 g of magnesium intravenously immediately post surgery and on the first post-operative day. We developed a propensity score for the probability of receiving sotalol and magnesium after coronary surgery. 89 patients from the sotalol and magnesium group were successfully matched with 89 unique coronary surgery patients who did not receive either sotalol or magnesium with an identical propensity score. Results Preoperative characteristics were well matched between groups. There was no significant difference with respect to in-hospital mortality between groups (sotalol and magnesium 1.1% versus control 4.5%; p = 0.17). The incidence of atrial fibrillation in the sotalol and magnesium group was 13.5% compared to 27.0% in the controls (p = 0.025). Conclusion The combination of sotalol and magnesium can significantly reduce the incidence of post-operative atrial fibrillation following coronary surgery.
2021
Background: The optimal therapeutic strategy for high-risk postoperative atrial fibrillation (POAF) remains less well defined. Our objectives were to investigate the efficacy of prophylactic metoprolol versus low-dose sotalol regimens to prevent high-risk atrial fibrillation (AF) following coronary artery bypass surgery (CABG). Methods: We assigned 113 consecutive patients referred for CABG to either metoprolol or low-dose sotalol regimen. The primary end-point was the frequency of POAF during the 6-week follow-up. Results: Out of 113 patients enrolled, 52.2% % received metoprolol (n= 59) while 44.8% received sotalol (n= 54). The frequency of POAF at follow-up was significantly higher among the metoprolol group (59.3 % versus 50 %; P=0.017). The predictors of POAF were: age > 60 years (OR: 1.86 (1.01-4.41); P= 0.03), EF (OR: 2 (1.05-3.83); P= 0.02), and sotalol was protective against POAF (OR= 0.49%; (95% CI=0.25 -0.97); P=0.02). The length of hospital stay was significantly high...