Bagshaw Sean M, Galbraith P Diane, Mitchell L Brent, Sauve Reg, Exner Derek V, Ghali William A
Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
Ann Thorac Surg. 2006 Nov;82(5):1927-37. doi: 10.1016/j.athoracsur.2006.06.032.
Amiodarone has been proposed to decrease atrial fibrillation after cardiac surgery. The literature was systematically reviewed for randomized trials comparing amiodarone with control for prevention of atrial fibrillation. Data were extracted on study characteristics, quality, and incidence of atrial fibrillation, cardiovascular outcomes, and length of hospitalization. Nineteen trials were included. Amiodarone reduced the odds ratio of atrial fibrillation (0.50; 95% confidence interval [CI]: 0.43 to 0.59, p < 0.0001), ventricular tachyarrhythmias (0.39; 95% CI: 0.26 to 0.58, p < 0.0001), and strokes (0.53; 95% CI: 0.30 to 0.92, p = 0.02). Amiodarone reduced hospital stay (0.6 days; 95% CI: 0.4 to 0.8, p < 0.0001). Amiodarone decreased atrial fibrillation, reduced perioperative ventricular tachyarrhythmias and strokes, and reduced duration of hospitalization. The current evidence supports recommending the routine use of perioperative amiodarone for cardiac surgery.
胺碘酮已被提议用于降低心脏手术后房颤的发生率。我们对相关文献进行了系统回顾，纳入了比较胺碘酮与对照组预防房颤的随机试验。提取了有关研究特征、质量、房颤发生率、心血管结局及住院时间的数据。共纳入19项试验。胺碘酮降低了房颤的比值比（0.50；95%置信区间[CI]：0.43至0.59，p<0.0001）、室性快速心律失常（0.39；95%CI：0.26至0.58，p<0.0001）及卒中（0.53；95%CI：0.30至0.92，p = 0.02）。胺碘酮缩短了住院时间（0.6天；95%CI：0.4至0.8，p<0.0001）。胺碘酮可降低房颤发生率，减少围手术期室性快速心律失常及卒中的发生，并缩短住院时间。目前证据支持推荐在心脏手术围手术期常规使用胺碘酮。
