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. 靜脈胺碘酮急診轉復高齡房顫的療效與安全性. 吉林醫學, 2016, 37(5): 1178-1179.
2.	黃千曉. 探討胺碘酮在重度左心衰竭合并房顫臨床治療中的應用. 心血管病防治知識, 2016, 6: 64-66.
3.	黃丹, 黃鶴, 王志強, 等. 胺碘酮預防心臟外科術后房顫有效性和安全性的Meta分析. 中國循證心血管醫學雜志, 2015, 7(2): 165-169.
4.	顧松, 蘇丕雄, 劉巖, 等. 小劑量胺碘酮預防冠狀動脈旁路移植術后心房纖顫. 中華胸心血管外科雜志, 2003, 19(2): 89-91.
5.	王璽勝, 梅運清, 李愛萍, 等. 胺碘酮對冠狀動脈旁路移植術后心房纖顫的預防作用. 中華胸心血管外科雜志, 2006, 22(3): 208.
6.	韓慶奇, 徐志云, 張寶仁, 等. 胺碘酮在預防冠狀動脈旁路移植術后房顫中的作用研究. 第二軍醫大學學報, 2006, 27(9): 973-976.
7.	施盛, 虞敏, 葉一舟, 等. 圍術期應用胺碘酮對冠狀動脈旁路移植術后心房顫動的作用. 中國心臟起搏與心電生理雜志, 2007, 21(1): 29-31.
8.	房勤, 谷天祥, 王春, 等. 胺碘酮預防冠狀動脈旁路移植術后心房顫動. 中華心血管病雜志, 2007, 35(10): 933-935.
9.	丁平. 心臟術后心房纖顫藥物治療臨床研究. 第二軍醫大學, 2008.
10.	葉新, 馬挺, 楊大昕, 等. 術中靜脈注射胺碘酮對體外循環冠狀動脈旁路移植術患者轉歸的影響. 中華麻醉學雜志, 2009, 29(9): 800-802.
11.	方穎, 張兆光, 顧承雄, 等. 術前低劑量胺碘酮預防非體外循環冠狀動脈旁路移植術后心房顫動. 中華老年醫學雜志, 2009, 28(6): 457-459.
12.	李慶志, 祝滬軍, 李欣, 等. 冠狀動脈旁路移植術后新發房顫的圍術期預防方案的研究. 齊齊哈爾醫學院學報, 2010, 31(16): 2532-2534.
13.	肖巍, 張健群, 孔晴宇, 等. 圍術期應用胺碘酮預防心臟不停跳冠狀動脈搭橋術后房顫的研究. 中華臨床醫師雜志(電子版), 2012, 6(13): 39-44.
14.	呂振乾, 徐平, 楊春悅. 低劑量胺碘酮對 OPCABG 術后早期房顫預防作用的研究. 交通醫學, 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.	宋靜華, 李培軍, 李軍山. 靜脈胺碘酮治療冠狀動脈旁路移植術后心房顫動伴快速心室率的療效和安全性. 中國心臟起搏與心電生理雜志, 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.	梅陽, 黃鶴. 胺碘酮治療慢性心力衰竭并發室性心律失常的 Meta 分析. 疑難病雜志, 2014, 13(9): 942-946, 951.
26.	王海平, 姜先雁, 鳳瑋, 等. 口服胺碘酮預防 70 歲以上老年患者冠狀動脈旁路移植術后心房顫動的發生. 中國胸心血管外科臨床雜志, 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.	楊彥偉, 李書聞, 金沐, 等. 單次胺碘酮預防男性急診體外循環冠狀動脈旁路移植術后心房顫動的療效評價. 心肺血管病雜志, 2014, 33(3): 398-401.

1. 何日德. 靜脈胺碘酮急診轉復高齡房顫的療效與安全性. 吉林醫學, 2016, 37(5): 1178-1179.
2. 黃千曉. 探討胺碘酮在重度左心衰竭合并房顫臨床治療中的應用. 心血管病防治知識, 2016, 6: 64-66.
3. 黃丹, 黃鶴, 王志強, 等. 胺碘酮預防心臟外科術后房顫有效性和安全性的Meta分析. 中國循證心血管醫學雜志, 2015, 7(2): 165-169.
4. 顧松, 蘇丕雄, 劉巖, 等. 小劑量胺碘酮預防冠狀動脈旁路移植術后心房纖顫. 中華胸心血管外科雜志, 2003, 19(2): 89-91.
5. 王璽勝, 梅運清, 李愛萍, 等. 胺碘酮對冠狀動脈旁路移植術后心房纖顫的預防作用. 中華胸心血管外科雜志, 2006, 22(3): 208.
6. 韓慶奇, 徐志云, 張寶仁, 等. 胺碘酮在預防冠狀動脈旁路移植術后房顫中的作用研究. 第二軍醫大學學報, 2006, 27(9): 973-976.
7. 施盛, 虞敏, 葉一舟, 等. 圍術期應用胺碘酮對冠狀動脈旁路移植術后心房顫動的作用. 中國心臟起搏與心電生理雜志, 2007, 21(1): 29-31.
8. 房勤, 谷天祥, 王春, 等. 胺碘酮預防冠狀動脈旁路移植術后心房顫動. 中華心血管病雜志, 2007, 35(10): 933-935.
9. 丁平. 心臟術后心房纖顫藥物治療臨床研究. 第二軍醫大學, 2008.
10. 葉新, 馬挺, 楊大昕, 等. 術中靜脈注射胺碘酮對體外循環冠狀動脈旁路移植術患者轉歸的影響. 中華麻醉學雜志, 2009, 29(9): 800-802.
11. 方穎, 張兆光, 顧承雄, 等. 術前低劑量胺碘酮預防非體外循環冠狀動脈旁路移植術后心房顫動. 中華老年醫學雜志, 2009, 28(6): 457-459.
12. 李慶志, 祝滬軍, 李欣, 等. 冠狀動脈旁路移植術后新發房顫的圍術期預防方案的研究. 齊齊哈爾醫學院學報, 2010, 31(16): 2532-2534.
13. 肖巍, 張健群, 孔晴宇, 等. 圍術期應用胺碘酮預防心臟不停跳冠狀動脈搭橋術后房顫的研究. 中華臨床醫師雜志(電子版), 2012, 6(13): 39-44.
14. 呂振乾, 徐平, 楊春悅. 低劑量胺碘酮對 OPCABG 術后早期房顫預防作用的研究. 交通醫學, 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. 宋靜華, 李培軍, 李軍山. 靜脈胺碘酮治療冠狀動脈旁路移植術后心房顫動伴快速心室率的療效和安全性. 中國心臟起搏與心電生理雜志, 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. 梅陽, 黃鶴. 胺碘酮治療慢性心力衰竭并發室性心律失常的 Meta 分析. 疑難病雜志, 2014, 13(9): 942-946, 951.
26. 王海平, 姜先雁, 鳳瑋, 等. 口服胺碘酮預防 70 歲以上老年患者冠狀動脈旁路移植術后心房顫動的發生. 中國胸心血管外科臨床雜志, 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. 楊彥偉, 李書聞, 金沐, 等. 單次胺碘酮預防男性急診體外循環冠狀動脈旁路移植術后心房顫動的療效評價. 心肺血管病雜志, 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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