Effects of Diltiazem Prophylaxis on the Incidence and Clinical Outcome of Atrial Arrythmias after Thoracic Surgery
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 ([&amp;gt;=]60 years) or pneumonectomy ([&amp;gt;=]18 years) and orally thereafter for 14 days. The primary end point with respect to efficacy was a sustained ([&amp;gt;=]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.
Econometrics | Medicine and Health Sciences
Journal of Thoracic and Cardiovascular Surgery
Amar, D.; Roistacher, N.; Rusch, V. W.; Leung, Denis H. Y.; Ginsburg, I.; Zhang, H.; Bains, M. S.; Downey, R. J.; Korst, R.; and Ginsberg, R.J..
Effects of Diltiazem Prophylaxis on the Incidence and Clinical Outcome of Atrial Arrythmias after Thoracic Surgery. (2000). Journal of Thoracic and Cardiovascular Surgery. 120, (4), 790-798. Research Collection School Of Economics.
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