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After cardiac surgery, about one third of patients develop a sustained atrial tachyarrhythmia (usually atrial fibrillation or flutter), which can prolong hospitalization and increase the risk for stroke. These researchers in Canada randomized 601 patients scheduled to undergo nonemergent cardiac surgery (CABG and/or valve replacement or repair) to receive oral amiodarone (10 mg/kg/day, divided into two doses) or placebo. Treatment was started 6 days before surgery and stopped 6 days after surgery. About 57% of patients were taking beta-blockers preoperatively, and 46% were taking ACE inhibitors.
Incidence of the primary endpoint — an atrial tachyarrhythmia of ≥5 minutes’ duration that prompted treatment — was significantly lower among amioda…