Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection

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

“…Postoperative administration of intravenous amiodarone may be considered to prevent POAF in patients undergoing esophagectomy [3], [15], [17], [26], [29], [42], [95], [97], [104], [106], [116], [118], [119]. (LOE B)…”

“…The authors acknowledged that right-sided pneumonectomy in itself was a well-established risk for ARDS, but nevertheless cautioned on the use of amiodarone for AF prevention after pulmonary resection. Since then a number of observational and more recent prospective randomized trials failed to find a link between use of amiodarone for AF prevention and ARDS immediately after pulmonary resection [17], [95], [97], [116], [118]. A number of other studies used amiodarone for acute treatment of AF following general thoracic surgery, and none of these reported amiodarone-related pulmonary toxicity.…”

Inflammation Effects on the Electrical Properties of Atrial Tissue and Inducibility of Postoperative Atrial Fibrillation

“…Trials with amiodarone, digoxin, and verapamil have shown a reduction but not an elimination of this arrhythmia [13][14][15][16]. In addition, these pharmacological attacks have not come without side effects such as bradycardia, hypotension, gastrointestinal intolerance, and QT interval prolongation with proarrhythmia [17].…”

Postoperative Care of Patients Undergoing Lung Resection

“…Recent reports, however, attest to the efficacy and high safety of amiodarone in thoracic surgery. In the study by Lanza et al [69] the amiodarone-treated patients (200 mg orally every 8 hours continued until hospital discharge) showed an incidence of AF of 9.7%, compared with 33% in the control group. Tisdale et al [70] demonstrated that Amiodarone prophylaxis significantly reduced the incidence of AF after anatomic pulmonary resection.…”