Effects of diltiazem prophylaxis on the incidence and clinical outcome of atrial arrhythmias after thoracic surgery Journal Article
| Authors: | Amar, D.; Roistacher, N.; Rusch, V. W.; Leung, D. H. Y.; Ginsburg, I.; Zhang, H.; Bains, M. S.; Downey, R. J.; Korst, R. J.; Ginsberg, R. J. |
| Article Title: | Effects of diltiazem prophylaxis on the incidence and clinical outcome of atrial arrhythmias after thoracic surgery |
| Abstract: | Objectives: We sought to determine whether early prophylaxis with an L-type calcium channel blocker reduces the incidence and morbidity associated with atrial fibrillation/flutter and supraventricular tachyarrhythmia after major thoracic operations. Methods: In this randomized, double-blind, placebo-controlled study, 330 patients were given either intravenous diltiazem (n = 167) or placebo (n = 163) immediately after lobectomy (≥60 years) or pneumonectomy (≥18 years) and orally thereafter for 14 days. The primary end point with respect to efficacy was a sustained (≥15 minutes) or clinically significant atrial arrhythmia during treatment. Results: Postoperative atrial arrhythmias (atrial fibrillation/flutter = 60; supraventricular tachyarrhythmias = 5) occurred in 25 (15%) of the 167 patients in the diltiazem group and 40 (25%) of the 163 patients in the placebo group (P = .03). When compared with placebo, diltiazem nearly halved the incidence of clinically significant arrhythmias (17/167 [10%] vs 31/163 [19%], P = .02). The 2 groups did not differ in the incidence of other major postoperative complications or overall duration or costs of hospitalization. No serious adverse effects caused by diltiazem were seen. Conclusions: After major thoracic operations, prophylactic diltiazem reduced the incidence of clinically significant atrial arrhythmias in patients considered at high risk for this complication. |
| Keywords: | adult; controlled study; treatment outcome; aged; middle aged; major clinical study; clinical trial; placebo; controlled clinical trial; randomized controlled trial; incidence; morbidity; postoperative complications; prophylaxis; double blind procedure; double-blind method; administration, oral; thorax surgery; heart atrium arrhythmia; heart atrium fibrillation; atrial fibrillation; calcium channel blocking agent; supraventricular tachycardia; injections, intravenous; hospital costs; diltiazem; pulmonary surgical procedures; heart atrium flutter; atrial flutter; calcium channel blockers; humans; human; male; female; priority journal; article; tachycardia, supraventricular |
| Journal Title: | Journal of Thoracic and Cardiovascular Surgery |
| Volume: | 120 |
| Issue: | 4 |
| ISSN: | 0022-5223 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2000-10-01 |
| Start Page: | 790 |
| End Page: | 798 |
| Language: | English |
| PUBMED: | 11003764 |
| PROVIDER: | scopus |
| DOI: | 10.1067/mtc.2000.109538 |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work