Prophylactic effect of Amiodarone and in combination with vitamin C in reducing atrial fibrillation after coronary artery bypass


Submitted: 24 March 2020
Accepted: 25 January 2021
Published: 1 September 2021
Abstract Views: 1004
PDF: 391
HTML: 5
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

  • Alireza Kamali Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran, Islamic Republic of.
  • Samira Yavari Department of Cardiovascular Surgery, Arak University of Medical Science, Arak, Iran, Islamic Republic of.
  • Bijan Yazdi Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran, Islamic Republic of.
  • Alireza Rostami Department of Cardiovascular Surgery, Arak University of Medical Science, Arak, Iran, Islamic Republic of.

Atrial fibrillation (AF) is the most common arrhythmia following cardiac surgery, leading to hemodynamic impairment and increased mortality and morbidity after coronary artery bypass grafting (CABG) and increases hospitalization. Due to the antioxidant and anti-inflammatory effects of vitamin C as well as the antiarrhythmic effect of amiodarone in reducing the incidence of atrial fibrillation after coronary artery bypass grafting, we decided to compare and evaluate the prophylactic effect of amiodarone alone and in combination with vitamin C in controlling this complication. In this double-blind clinical trial, patients were divided into two equal groups of amiodarone (300 mg amiodarone bolus during 20-30 minutes) and amiodarone + vitamin C (150 mg amiodarone and 2g vitamin C combination). Each group included 42 patients. All data were analyzed by SPSS 19 software and statistical tests of ANOVA, Chi-square and Repeated Measure. There was a significant difference between the two groups of amiodarone and amiodarone+vitamin C (p-value = 0.01) and the mean incidence of AF in the amiodarone +vitamin C group was significantly lower than that of amiodarone alone. Other arrhythmias were also lower in the amiodarone +vitamin C group than in the amiodarone group alone. The use offibrillation after CABG compared with prophylactic amiodarone alone, but did not have a significant effect on decreasing ICU stay(discharge) and duration of hospitalization.


Mirmansoori A, Farzi F, Sedighinejad A, Imantalab V, Mohammadzadeh A, Atrkar Roushan Z, Ghazanfar Tehran S, Nemati M, Dehghan A. The Effect of Desmopressin on the Amount of Bleeding in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Cardiopulmonary Bypass Pump After Taking Anti-Platelet Medicine. Anesth Pain Med. 2016 Jul 26;6(5):e39226. DOI: https://doi.org/10.5812/aapm.39226

Habibollahi P, Jam SH, Vahdati SS, Baghi HM, Amiri H. Amiodaron in atrial fibrillation: post coronary artery bypass graft. World J Emerg Med. 2016;7(4):250-254. DOI: https://doi.org/10.5847/wjem.j.1920-8642.2016.04.002

Lip GY, Zarifis J, Watson RD, Beevers DG. Physician variation in the management of patients with atrial fibrillation. Heart. 1996 Feb;75(2):200-5. DOI: https://doi.org/10.1136/hrt.75.2.200

Buckley MS, Nolan PE Jr, Slack MK, Tisdale JE, Hilleman DE, Copeland JG. Amiodarone prophylaxis for atrial fibrillation after cardiac surgery: meta-analysis of dose response and timing of initiation. Pharmacotherapy. 2007 Mar;27(3):360-8. DOI: https://doi.org/10.1592/phco.27.3.360

Tiryakioglu O, Demirtas S, Ari H, Tiryakioglu SK, Huysal K, Selimoglu O, Ozyazicioglu A. Magnesium sulphate and amiodarone prophylaxis for prevention of postoperative arrhythmia in coronary by-pass operations. J Cardiothorac Surg. 2009 Feb 20;4:8. DOI: https://doi.org/10.1186/1749-8090-4-8

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 C. Amiodarone prophylaxis for atrial fibrillation of high-risk patients after coronary bypass grafting: a prospective, double-blinded, placebo-controlled, randomized study. Eur Heart J. 2006 Jul;27(13):1584-91. Epub 2006 Jun 7. DOI: https://doi.org/10.1093/eurheartj/ehl082

Jalalian R, Ghafari R, Ghazanfari P. Comparing the therapeutic effects of carvedilol and metoprolol on prevention of atrial fibrillation after coronary artery bypass surgery, a double-blind study. Int Cardiovasc Res J. 2014 Sep;8(3):111-5. Epub 2014 Sep 1.

Moludi J, Keshavarz S, Mohammad Javad H, Rahimi Frooshani A, Sadeghpour A, Salarkia S, Gholizadeh F. Coenzyme Q10 effect in prevention of atrial fibrillation after Coronary Artery Bypass Graft: double-blind randomized clinical trial. Tehran Univ Med J. 2015; 73: 79-85.

Samadikhah J, Golzari SE, Sabermarouf B, Karimzadeh I, Tizro P, Mohammad Khanli H, Ghabili K. Efficacy of Combination Therapy of Statin and Vitamin C in Comparison with Statin in the Prevention of Post-CABG Atrial Fibrillation. Adv Pharm Bull. 2014;4(1):97-100. Epub 2013 Dec 23.

Bagshaw SM, Galbraith PD, Mitchell LB, Sauve R, Exner DV, Ghali WA. Prophylactic amiodarone for prevention of atrial fibrillation after cardiac surgery: a meta-analysis. Ann Thorac Surg. 2006 Nov;82(5):1927-37. DOI: https://doi.org/10.1016/j.athoracsur.2006.06.032

Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, Crijns HJ, Damiano RJ Jr, Davies DW, DiMarco J, Edgerton J, Ellenbogen K, Ezekowitz MD, Haines DE, Haissaguerre M, Hindricks G, Iesaka Y, Jackman W, Jalife J, Jais P, Kalman J, Keane D, Kim YH, Kirchhof P, Klein G, Kottkamp H, Kumagai K, Lindsay BD, Mansour M, Marchlinski FE, McCarthy PM, Mont JL, Morady F, Nademanee K, Nakagawa H, Natale A, Nattel S, Packer DL, Pappone C, Prystowsky E, Raviele A, Reddy V, Ruskin JN, Shemin RJ, Tsao HM, Wilber D. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace. 2012 Apr;14(4):528-606. Epub 2012 Mar 1. DOI: https://doi.org/10.1016/j.hrthm.2011.12.016

Davis RC, Hobbs FD, Kenkre JE, Roalfe AK, Iles R, Lip GY, Davies MK. Prevalence of atrial fibrillation in the general population and in high-risk groups: the ECHOES study. Europace. 2012 Nov;14(11):1553-9. Epub 2012 Apr 5. DOI: https://doi.org/10.1093/europace/eus087

Friberg J, Buch P, Scharling H, Gadsbphioll N, Jensen GB. Rising rates of hospital admissions for atrial fibrillation. Epidemiology. 2003 Nov;14(6):666-72. DOI: https://doi.org/10.1097/01.ede.0000091649.26364.c0

Kojuri J, Mahmoodi Y, Jannati M, Shafa M, Ghazinoor M, Sharifkazemi MB. Ability of amiodarone and propranolol alone or in combination to prevent post-coronary bypass atrial fibrillation. Cardiovasc Ther. 2009 Winter;27(4):253-8. DOI: https://doi.org/10.1111/j.1755-5922.2009.00100.x

Stanger O, Aigner I, Schimetta W, Wonisch W. Antioxidant supplementation attenuates oxidative stress in patients undergoing coronary artery bypass graft surgery. Tohoku J Exp Med. 2014 Feb;232(2):145-54. DOI: https://doi.org/10.1620/tjem.232.145

Kamali A, Sanatkar A, Sharifi M, Moshir E. Evaluation of amiodarone versus metoprolol in treating atrial fibrillation after coronary artery bypass grafting. Interv Med Appl Sci. 2017 Jun;9(2):51-55. DOI: https://doi.org/10.1556/1646.9.2017.11

Harling L, Rasoli S, Vecht JA, Ashrafian H, Kourliouros A, Athanasiou T. Do antioxidant vitamins have an anti-arrhythmic effect following cardiac surgery? A meta-analysis of randomised controlled trials. Heart. 2011 Oct;97(20):1636-42. Epub 2011 Aug 23. DOI: https://doi.org/10.1136/heartjnl-2011-300245

Kamali, A., Yavari, S., Yazdi, B., & Rostami, A. (2021). Prophylactic effect of Amiodarone and in combination with vitamin C in reducing atrial fibrillation after coronary artery bypass. European Journal of Translational Myology, 31(3). https://doi.org/10.4081/ejtm.2021.8981

Downloads

Download data is not yet available.

Citations