Effectiveness of intra‐operative topical amiodarone for prevention of postcardiac surgery new‐onset atrial fibrillation: A review of current evidence. Issue 12 (20th November 2022)

• Record Type: Journal Article
• Authors: Chen, Xingyu; Sartor, Cam; Zhang, Shetuan; Baranchuk, Adrian; Ross‐White, Amanda; Fernandez, Angel Luis; El‐Diasty, Mohammad
• Is Part Of: Journal of cardiac surgery. Volume 37:Issue 12(2022)
• Page Start: 5371
• Page End: 5378
• Publication Date: 2022-11-20
• Subjects: amiodarone -- anti‐arrhythmic -- cardiac surgery -- epicardial therapies -- intraoperative interventions -- K ion channels -- pericardial therapies -- postoperative adverse effects -- postoperative atrial fibrillation -- postoperative outcomes -- surgical innovation; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.17190
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Background: Postoperative atrial fibrillation (POAF) is one of the most common complications following cardiac surgery and is associated with increased morbidity. Intraoperative topical amiodarone application on epicardial tissue has been shown to reduce systemic concentrations while maintaining therapeutic myocardial concentrations, thereby, lowering the risk of extracardiac adverse effects associated with oral and intravenous amiodarone therapy. However, the efficacy and safety of topical amiodarone in preventing POAF is unclear. Objectives: This study summarizes the clinical studies to‐date that have investigated the efficacy and safety of topical amiodarone administration in preventing POAF following cardiac surgery. Methods: A database search was conducted using Medline, Embase, and Cochrane Library to identify relevant studies. Abstracts were screened and data were extracted from relevant full‐text articles that met the inclusion and exclusion criteria. Results: The search returned four studies with variable findings on the effect of topical amiodarone therapy on the incidence of POAF, cardiac effects, extracardiac effects, and hospital length of stay. Conclusion: Prophylactic topical application of amiodarone may be effective and safe for preventing post‐operative new‐onset atrial fibrillation. Further investigation is required to evaluate the efficacy and safety of topical amiodadrone therapy before it can be widely integrated into current practice.