Preoperative heart rate and efficacy of diltiazem to prevent postoperative atrial fibrillation Meeting Abstract

  


Authors: Amar, D.; Zhang, H.; Roistacher, N.; Rusch, V. W.
Abstract Title: Preoperative heart rate and efficacy of diltiazem to prevent postoperative atrial fibrillation
Meeting Title: 2003 Annual Meeting of the American Society of Anesthesiologists
Abstract: Background: Age gtoreq60 yr and preoperative heart rate (HR) gtoreq75 bpm have been identified as risk factors for postoperative atrial fibrillation/flutter (PAF). Prophylactic diltiazem administered after surgery has been shown to decrease the rate of PAF. This retrospective study examined whether this benefit of diltiazem therapy is rate-dependent. Methods: In a randomized, double-blind, placebo-controlled study 290 patients gtoreq60 yr received either intravenous diltiazem (n=149) or placebo (n=141) immediately after lobectomy (n=231) or pneumonectomy (n=60) and orally thereafter for 14 days. Preoperative HR was obtained from a 12-lead ECG. Data were analyzed with student's t- or Fisher's exact tests. Results: There were no differences in age or operation type between the groups, Table. Among diltiazem treated patients, the incidence of PAF was significantly lower in patients with a preoperative HR gtoreq 75 compared to those with a HR< 75, 8/79 vs. 16/70, P=0.04, respectively. The incidence of PAF was also lower (P=0.05) when diltiazem and placebo groups were compared, Table. Conclusions: The efficacy of prophylactic diltiazem given immediately after thoracotomy to reduce or prevent PAF is higher in patients with a greater preoperative HR. These findings support the hypothesis that diltiazem is more effective in conditions consistent with adrenergic hyperactivity and calcium channel activation..
Keywords: preoperative heart rate; randomized double-blind placebo-controlled study
Journal Title: Anesthesiology Abstracts of Scientific Papers Annual Meeting
Issue: 2003
Meeting Dates: 2003 Oct 11-15
Meeting Location: San Francisco, CA
Publisher: American Society of Anesthesiologists  
Date Published: 2003-01-01
Language: English
ACCESSION: BCI:BCI200400010875
PROVIDER: biosis
Notes: Meeting Abstract: A-238-- 2003 Annual Meeting of the American Society of Anesthesiologists -- San Francisco, CA, USA -- October 11-15, 2003 -- American Society of Anesthesiologists -- Source: Biosis