Efficacy of amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FU Jiayu ¹ ,  SHEN Chunjian ^1,2 , GAO Shun ² , LIU Wei ² , LIU Chao ² , XIE Bumin ² , WU Wenzhe ² , GE Yao ²

1. Shenyang Medical College, Shenyang, 110035, P.R.China;
2. Department of Cardiac Surgery, the Second Affiliated Hospital of Shenyang Medical College, Shenyang, 110035, P.R.China;

Corresponding author：

SHEN Chunjian, Email: shenchunjian1976@hotmil.com

Keywords：

Coronary artery bypass grafting; atrial fibrillation; amiodarone

DOI：

10.7507/1007-4848.201708040

Video：

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Objective To evaluate efficacy of amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting. Methods CBM (from January 1978 to August 2017), CNKI (from January 1987 to August 2017), VIP (from January 1989 to August 2017), Wanfang (from January 1998 to August 2017) and PubMed (from January 1989 to August 2017) databases were searched. The articles were selected based on the inclusion and exclusion criteria. Quality of articles was assessed by improved Jadad scale. Statistical analysis was performed using RevMan 5.3. Results There were 19 articles meeting inclusion criteria including 2 817 patients and all were randomized controlled trial (RCT). There were 16 articles with high quality and 3 articles with low quality by improved Jadad scale. Compared with the placebo, amiodarone had a significant effect on reducing the incidence of atrial fibrillation after coronary artery bypass grafting (RR=0.37, 95% CI 0.28 to 0.50, P<0.000 01) and different administration models and time of amiodarone had effect on the atrial fibrillation after aterial bypass grafting (P<0.05). Conclusion Compared with the placebo, amiodarone is effective in reducing the incidence of atrial fibrillation after coronary artery bypass grafting.

Citation： FU Jiayu, SHEN Chunjian, GAO Shun, LIU Wei, LIU Chao, XIE Bumin, WU Wenzhe, GE Yao. Efficacy of amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(5): 420-426. doi: 10.7507/1007-4848.201708040 Copy

1.	何日德. 静脉胺碘酮急诊转复高龄房颤的疗效与安全性. 吉林医学, 2016, 37(5): 1178-1179.
2.	黄千晓. 探讨胺碘酮在重度左心衰竭合并房颤临床治疗中的应用. 心血管病防治知识, 2016, 6: 64-66.
3.	黄丹, 黄鹤, 王志强, 等. 胺碘酮预防心脏外科术后房颤有效性和安全性的Meta分析. 中国循证心血管医学杂志, 2015, 7(2): 165-169.
4.	顾松, 苏丕雄, 刘岩, 等. 小剂量胺碘酮预防冠状动脉旁路移植术后心房纤颤. 中华胸心血管外科杂志, 2003, 19(2): 89-91.
5.	王玺胜, 梅运清, 李爱萍, 等. 胺碘酮对冠状动脉旁路移植术后心房纤颤的预防作用. 中华胸心血管外科杂志, 2006, 22(3): 208.
6.	韩庆奇, 徐志云, 张宝仁, 等. 胺碘酮在预防冠状动脉旁路移植术后房颤中的作用研究. 第二军医大学学报, 2006, 27(9): 973-976.
7.	施盛, 虞敏, 叶一舟, 等. 围术期应用胺碘酮对冠状动脉旁路移植术后心房颤动的作用. 中国心脏起搏与心电生理杂志, 2007, 21(1): 29-31.
8.	房勤, 谷天祥, 王春, 等. 胺碘酮预防冠状动脉旁路移植术后心房颤动. 中华心血管病杂志, 2007, 35(10): 933-935.
9.	丁平. 心脏术后心房纤颤药物治疗临床研究. 第二军医大学, 2008.
10.	叶新, 马挺, 杨大昕, 等. 术中静脉注射胺碘酮对体外循环冠状动脉旁路移植术患者转归的影响. 中华麻醉学杂志, 2009, 29(9): 800-802.
11.	方颖, 张兆光, 顾承雄, 等. 术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房颤动. 中华老年医学杂志, 2009, 28(6): 457-459.
12.	李庆志, 祝沪军, 李欣, 等. 冠状动脉旁路移植术后新发房颤的围术期预防方案的研究. 齐齐哈尔医学院学报, 2010, 31(16): 2532-2534.
13.	肖巍, 张健群, 孔晴宇, 等. 围术期应用胺碘酮预防心脏不停跳冠状动脉搭桥术后房颤的研究. 中华临床医师杂志(电子版), 2012, 6(13): 39-44.
14.	吕振乾, 徐平, 杨春悦. 低剂量胺碘酮对 OPCABG 术后早期房颤预防作用的研究. 交通医学, 2013, 27(2): 183-184, 187.
15.	Guarnieri T. Intravenous antiarrhythmic regimens with focus on amiodarone for prophylaxis of atrial fibrillation after open heart surgery. Am J Cardiol, 1999, 84(9A): 152R-155R.
16.	Lee SH, Chang CM, Lu MJ, et al. Intravenous amiodarone for prevention of atrial fibrillation after coronary artery bypass grafting. Ann Thorac Surg, 2000, 70(1): 157-161.
17.	Harahsheh BS, Sawalha WA. Effect of Amiodarone on atrial fibrillation after coronary artery bypass surgery. Saudi Med J, 2001, 22(9): 797-799.
18.	Yagdi T, Nalbantgil S, Ayik F, et al. Amiodarone reduces the incidence of atrial fibrillation after coronary artery bypass grafting. J Thorac Cardiovasc Surg, 2003, 125(6): 1420-1425.
19.	Kerstein J, Soodan A, Qamar M, et al. Giving IV and oral amiodarone perioperatively for the prevention of postoperative atrial fibrillation in patients undergoing coronary artery bypass surgery: the GAP study. Chest, 2004, 126(3): 716-724.
20.	Budeus M, Hennersdorf M, Perings S, et al. Amiodarone prophylaxis for atrial fibrillation of high-risk patients after coronary bypass grafting: a prospective, double-blinded, placebo-controlled, randomized study. Eur Heart J, 2006, 27(13): 1584-1591.
21.	Turk T, Ata Y, Vural H, et al. Intravenous and oral amiodarone for the prevention of postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass surgery. Heart Surg Forum, 2007, 10(4): E299-E303.
22.	Roshanali F, Mandegar MH, Yousefnia MA, et al. Prevention of atrial fibrillation after coronary artery bypass grafting via atrial electromechanical interval and use of amiodarone prophylaxis. Interact Cardiovasc Thorac Surg, 2009, 8(4): 421-425.
23.	宋静华, 李培军, 李军山. 静脉胺碘酮治疗冠状动脉旁路移植术后心房颤动伴快速心室率的疗效和安全性. 中国心脏起搏与心电生理杂志, 2005, 19(6): 517.
24.	Narducci ML, Pelargonio G, Rio T, et al. Predictors of postoperative atrial fibrillation in patients with coronary artery disease undergoing cardiopulmonary bypass: a possible role for myocardial ischemia and atrial inflammation. J Cardiothorac Vasc Anesth, 2014, 28(3): 512-519.
25.	梅阳, 黄鹤. 胺碘酮治疗慢性心力衰竭并发室性心律失常的 Meta 分析. 疑难病杂志, 2014, 13(9): 942-946, 951.
26.	王海平, 姜先雁, 凤玮, 等. 口服胺碘酮预防 70 岁以上老年患者冠状动脉旁路移植术后心房颤动的发生. 中国胸心血管外科临床杂志, 2013, 20(4): 406-409.
27.	Vahdati SS, Samadikhah J, Hakim SH, et al. Comparion of the length of haspital stay between the patients with atrial fibrillationtreated with amiodarone and patients with normal sinus rhythm after coronary artery bypass graft. J Cardiovasc Thorac Res, 2012,4(1): 17-20.
28.	杨彦伟, 李书闻, 金沐, 等. 单次胺碘酮预防男性急诊体外循环冠状动脉旁路移植术后心房颤动的疗效评价. 心肺血管病杂志, 2014, 33(3): 398-401.

1. 何日德. 静脉胺碘酮急诊转复高龄房颤的疗效与安全性. 吉林医学, 2016, 37(5): 1178-1179.
2. 黄千晓. 探讨胺碘酮在重度左心衰竭合并房颤临床治疗中的应用. 心血管病防治知识, 2016, 6: 64-66.
3. 黄丹, 黄鹤, 王志强, 等. 胺碘酮预防心脏外科术后房颤有效性和安全性的Meta分析. 中国循证心血管医学杂志, 2015, 7(2): 165-169.
4. 顾松, 苏丕雄, 刘岩, 等. 小剂量胺碘酮预防冠状动脉旁路移植术后心房纤颤. 中华胸心血管外科杂志, 2003, 19(2): 89-91.
5. 王玺胜, 梅运清, 李爱萍, 等. 胺碘酮对冠状动脉旁路移植术后心房纤颤的预防作用. 中华胸心血管外科杂志, 2006, 22(3): 208.
6. 韩庆奇, 徐志云, 张宝仁, 等. 胺碘酮在预防冠状动脉旁路移植术后房颤中的作用研究. 第二军医大学学报, 2006, 27(9): 973-976.
7. 施盛, 虞敏, 叶一舟, 等. 围术期应用胺碘酮对冠状动脉旁路移植术后心房颤动的作用. 中国心脏起搏与心电生理杂志, 2007, 21(1): 29-31.
8. 房勤, 谷天祥, 王春, 等. 胺碘酮预防冠状动脉旁路移植术后心房颤动. 中华心血管病杂志, 2007, 35(10): 933-935.
9. 丁平. 心脏术后心房纤颤药物治疗临床研究. 第二军医大学, 2008.
10. 叶新, 马挺, 杨大昕, 等. 术中静脉注射胺碘酮对体外循环冠状动脉旁路移植术患者转归的影响. 中华麻醉学杂志, 2009, 29(9): 800-802.
11. 方颖, 张兆光, 顾承雄, 等. 术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房颤动. 中华老年医学杂志, 2009, 28(6): 457-459.
12. 李庆志, 祝沪军, 李欣, 等. 冠状动脉旁路移植术后新发房颤的围术期预防方案的研究. 齐齐哈尔医学院学报, 2010, 31(16): 2532-2534.
13. 肖巍, 张健群, 孔晴宇, 等. 围术期应用胺碘酮预防心脏不停跳冠状动脉搭桥术后房颤的研究. 中华临床医师杂志(电子版), 2012, 6(13): 39-44.
14. 吕振乾, 徐平, 杨春悦. 低剂量胺碘酮对 OPCABG 术后早期房颤预防作用的研究. 交通医学, 2013, 27(2): 183-184, 187.
15. Guarnieri T. Intravenous antiarrhythmic regimens with focus on amiodarone for prophylaxis of atrial fibrillation after open heart surgery. Am J Cardiol, 1999, 84(9A): 152R-155R.
16. Lee SH, Chang CM, Lu MJ, et al. Intravenous amiodarone for prevention of atrial fibrillation after coronary artery bypass grafting. Ann Thorac Surg, 2000, 70(1): 157-161.
17. Harahsheh BS, Sawalha WA. Effect of Amiodarone on atrial fibrillation after coronary artery bypass surgery. Saudi Med J, 2001, 22(9): 797-799.
18. Yagdi T, Nalbantgil S, Ayik F, et al. Amiodarone reduces the incidence of atrial fibrillation after coronary artery bypass grafting. J Thorac Cardiovasc Surg, 2003, 125(6): 1420-1425.
19. Kerstein J, Soodan A, Qamar M, et al. Giving IV and oral amiodarone perioperatively for the prevention of postoperative atrial fibrillation in patients undergoing coronary artery bypass surgery: the GAP study. Chest, 2004, 126(3): 716-724.
20. Budeus M, Hennersdorf M, Perings S, et al. Amiodarone prophylaxis for atrial fibrillation of high-risk patients after coronary bypass grafting: a prospective, double-blinded, placebo-controlled, randomized study. Eur Heart J, 2006, 27(13): 1584-1591.
21. Turk T, Ata Y, Vural H, et al. Intravenous and oral amiodarone for the prevention of postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass surgery. Heart Surg Forum, 2007, 10(4): E299-E303.
22. Roshanali F, Mandegar MH, Yousefnia MA, et al. Prevention of atrial fibrillation after coronary artery bypass grafting via atrial electromechanical interval and use of amiodarone prophylaxis. Interact Cardiovasc Thorac Surg, 2009, 8(4): 421-425.
23. 宋静华, 李培军, 李军山. 静脉胺碘酮治疗冠状动脉旁路移植术后心房颤动伴快速心室率的疗效和安全性. 中国心脏起搏与心电生理杂志, 2005, 19(6): 517.
24. Narducci ML, Pelargonio G, Rio T, et al. Predictors of postoperative atrial fibrillation in patients with coronary artery disease undergoing cardiopulmonary bypass: a possible role for myocardial ischemia and atrial inflammation. J Cardiothorac Vasc Anesth, 2014, 28(3): 512-519.
25. 梅阳, 黄鹤. 胺碘酮治疗慢性心力衰竭并发室性心律失常的 Meta 分析. 疑难病杂志, 2014, 13(9): 942-946, 951.
26. 王海平, 姜先雁, 凤玮, 等. 口服胺碘酮预防 70 岁以上老年患者冠状动脉旁路移植术后心房颤动的发生. 中国胸心血管外科临床杂志, 2013, 20(4): 406-409.
27. Vahdati SS, Samadikhah J, Hakim SH, et al. Comparion of the length of haspital stay between the patients with atrial fibrillationtreated with amiodarone and patients with normal sinus rhythm after coronary artery bypass graft. J Cardiovasc Thorac Res, 2012,4(1): 17-20.
28. 杨彦伟, 李书闻, 金沐, 等. 单次胺碘酮预防男性急诊体外循环冠状动脉旁路移植术后心房颤动的疗效评价. 心肺血管病杂志, 2014, 33(3): 398-401.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy of amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting: A systematic review and meta-analysis

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