Amiodarone Significantly Decreases Atrial Fibrillation in Patients Undergoing Surgery for Lung Cancer

2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

“…179 These studies varied in patient population, definition of perioperative complications, and what was done with the results of preoperative testing, including decisions about the appropriateness of proceeding with surgery. However, a consistent finding among the studies was that a low anaerobic threshold was predictive of perioperative cardiovascular complications, 171,173,177 postoperative death, 172,174,175 or midterm and late death after surgery. 174,179,180 An anaerobic threshold of approximately 10 mL O 2 /kg/ min was proposed as the optimal discrimination point, with a range in these studies of 9.9 mL O 2 /kg/min to 11 mL O 2 / kg/min.…”

“…See Cardiopulmonary exercise testing has been studied in different settings, including before abdominal aortic aneurysm surgery [172][173][174]180 ; major abdominal surgery (including abdominal aortic aneurysm resection) [175][176][177] ; hepatobiliary surgery 178 ; complex hepatic resection 171 ; lung resection 181 ; and colorectal, bladder, or kidney cancer surgery. 179 These studies varied in patient population, definition of perioperative complications, and what was done with the results of preoperative testing, including decisions about the appropriateness of proceeding with surgery.…”

2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures

“…al . [97] conducted a randomized, prospective, double-blind placebo-controlled study of amiodarone for prevention of AF following lung resection. Only 2 patients of the 122 who received amiodarone underwent pneumonectomy; the remainder underwent right side lobectomy or bilobectomy.…”

“…One potential difference in patients undergoing pneumonectomy in the Van Miegham study ([42] compared to these more recent trials [95]–[97] include the cumulative intravenous amiodarone dose administered. In the Van Mieghem study, intravenous amiodarone was administered as a bolus of 150 mg over 2 minutes, followed by a continuous infusion of 1200 mg over 24 hours for 3 consecutive days, for a possible cumulative intravenous amiodarone dose of 3750 mg.…”

“…The three patients who developed amiodarone-induced ARDS received cumulative intravenous amiodarone doses of 2150, 3750, and 3350 mg before discontinuation of therapy. In the more recent studies, patients received a cumulative intravenous amiodarone dose of 1050 mg, after which oral amiodarone was initiated [95], or a loading dose of 300 mg intravenous amiodarone before switching to oral amiodarone [97]. In the Barbetakis study [96], intravenous amiodarone was administered as a loading dose of 5 mg/kg over 5 minutes, followed by 15 mg/kg for an undefined time period.…”