0
Clinical Investigations: CARDIOLOGY |

Amiodarone vs Sotalol as Prophylaxis Against Atrial Fibrillation/Flutter After Heart Surgery*: A Meta-Analysis

Richard L. Wurdeman, PharmD; Aryan N. Mooss, MD, FCCP; Syed M. Mohiuddin, MD, FCCP; Thomas L. Lenz, PharmD
Author and Funding Information

*From the Creighton University School of Pharmacy and Allied Health Professions (Drs. Wurdeman and Lenz); and Cardiovascular Research (Dr. Mooss), the Division of Cardiology (Dr. Mohiuddin), Creighton University School of Medicine, Omaha, NE.

Correspondence to: Richard L. Wurdeman, PharmD, Creighton Cardiac Center, 3006 Webster St, Omaha, NE 68131; e-mail: rwurdem@cardiac.creighton.edu.



Chest. 2002;121(4):1203-1210. doi:10.1378/chest.121.4.1203
Text Size: A A A
Published online

Background: The incidence of supraventricular arrhythmias remains high following open-heart surgery. The most common of these arrhythmias are atrial fibrillation and flutter (AFF), for which treatment is not well defined. Recent studies have focused on prophylactically treating patients in an attempt to reduce postoperative AFF. Several studies have shown that sotalol and amiodarone are both effective in reducing AFF following heart surgery. However, no studies have been done comparing both drugs.

Methods: A meta-analysis was done to compare the efficacy of sotalol and amiodarone after bypass graft surgery. Randomized controlled trials were included if patients were clearly monitored, and the incidence of AFF was noted. Ten studies were included in the final analysis.

Results: Both amiodarone and sotalol were more effective than placebo treatment in reducing the incidence of postoperative AFF. However, when the data were pooled, no differences were noted between amiodarone and sotalol for efficacy (sotalol, − 21.5%; 95% confidence interval [CI], − 28.3 to − 14.6; amiodarone, − 14.1%; CI, − 20.1 to − 8.1), length of stay (sotalol, − 0.13 d; CI, − 0.33 to 0.07 d; amiodarone, − 0.18; CI, − 0.38 to 0.02 d), or adverse drug reactions causing drug termination (sotalol, 9.7%; CI, 0.086 to 19.3; amiodarone, 1.95%; CI, − 0.48 to 4.38).

Conclusions: This data would suggest that either drug could be used in a prophylactic regimen to reduce the incidence of AFF following heart surgery.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Pharmacologic Control of Rhythm*: American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac Surgery
Pharmacologic Prophylaxis*: American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac Surgery
Prevention of Atrial Fibrillation After Cardiac Surgery*: The Significance of Postoperative Oral Amiodarone
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543