Abstract
Background In randomized controlled trials, perioperative administration of amiodarone has been shown to reduce the incidence of postoperative atrial arrhythmias and length of stay (LOS) among patients undergoing coronary bypass surgery. However, little is known about the use or effectiveness of perioperative amiodarone in routine clinical practice. Methods and Results We studied patients ≥18 years old without a previous history of atrial or ventricular arrhythmias who underwent elective coronary bypass surgery between 2013 and 2014 within a network of 235 US hospitals. Perioperative amiodarone was defined as receipt of amiodarone either on the day of or the day preceding surgery. We used covariate-adjusted modeling and instrumental variable methods to examine the association between receipt of amiodarone and the development of atrial arrhythmias, in-hospital mortality, readmission, LOS, and cost. Of 12 758 patients, 2195 (17.2%) received perioperative amiodarone, 3330 (26.1%) developed atrial arrhythmias postoperatively, and the average LOS was 6.4 days (±2.6 days). Instrumental variable analysis showed that receipt of perioperative amiodarone was associated with lower risk of atrial arrhythmias (risk difference -11 percentage...Continue Reading
References
Mar 1, 1989·Progress in Cardiovascular Diseases·M S LauerR W DeSanctis
Sep 1, 1993·The Annals of Thoracic Surgery·L L CreswellJ L Cox
Aug 1, 1996·Circulation·S F ArankiH R Burstin
May 15, 1997·The New England Journal of Medicine·S R OmmenM S Stanton
Nov 14, 1997·Annals of Surgery·G H AlmassiK E Hammermeister
Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Jun 27, 2000·The American Journal of Cardiology·S C StamouP J Corso
Mar 29, 2001·The American Journal of Cardiology·M H KimK A Eagle
Aug 22, 2001·JAMA : the Journal of the American Medical Association·J P IoannidisJ Lau
Sep 20, 2002·The Annals of Thoracic Surgery·Stefano ForlaniLuigi Chiariello
Apr 26, 2003·The American Journal of Cardiology·Jennifer ZimmerSteven N Singh
Sep 8, 2005·Annals of Internal Medicine·Johan D AasboRichard G Trohman
Dec 29, 2005·JAMA : the Journal of the American Medical Association·L Brent MitchellAndrew Maitland
May 19, 2006·Statistics in Medicine·Peter C AustinGeoffrey M Anderson
Oct 26, 2006·The Annals of Thoracic Surgery·Sean M BagshawWilliam A Ghali
Dec 5, 2006·Current Opinion in Cardiology·L Brent Mitchell
Jan 18, 2007·JAMA : the Journal of the American Medical Association·Thérèse A StukelMarian J Vermeulen
Sep 17, 2009·Statistics in Medicine·Peter C Austin
Nov 28, 2009·European Heart Journal·Jeremy A RassenSebastian Schneeweiss
Jan 7, 2011·Journal of Clinical Epidemiology·Joshua J GagneSebastian Schneeweiss
Mar 9, 2011·Circulation·Valentin FusterUNKNOWN American College of Cardiology Foundation/American Heart Association Task Force
Mar 7, 2014·Statistics in Medicine·Michael BaiocchiDylan S Small
Oct 6, 2015·The New England Journal of Medicine·Derek J HausenloyUNKNOWN ERICCA Trial Investigators
Nov 17, 2016·World Journal of Cardiology·Amir S LotfiDaniel Engelman