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Long-Term Suppression of Atrial Fibrillation by Botulinum Toxin Injection Into Epicardial Fat Pads in Patients Undergoing Cardiac Surgery: One-Year Follow-Up of a Randomized Pilot Study.
Pokushalov, Evgeny; Kozlov, Boris; Romanov, Alexander; Strelnikov, Artem; Bayramova, Sevda; Sergeevichev, David; Bogachev-Prokophiev, Alexander; Zheleznev, Sergey; Shipulin, Vladimir; Lomivorotov, Vladimir V; Karaskov, Alexander; Po, Sunny S; Steinberg, Jonathan S.
Afiliação
  • Pokushalov E; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Kozlov B; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Romanov A; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Strelnikov A; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Bayramova S; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Sergeevichev D; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Bogachev-Prokophiev A; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Zheleznev S; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Shipulin V; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Lomivorotov VV; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Karaskov A; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Po SS; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
  • Steinberg JS; From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma H
Circ Arrhythm Electrophysiol ; 8(6): 1334-41, 2015 Dec.
Article em En | MEDLINE | ID: mdl-26486855
ABSTRACT

BACKGROUND:

Animal models suggest that the neurotransmitter inhibitor, botulinum toxin, when injected into the epicardial fat pads can suppress atrial fibrillation inducibility. The aim of this prospective randomized double-blind study was to compare the efficacy and safety of botulinum toxin injection into epicardial fat pads for preventing atrial tachyarrhythmias. METHODS AND

RESULTS:

Patients with history of paroxysmal atrial fibrillation and indication for coronary artery bypass graft surgery were randomized to botulinum toxin (Xeomin, Merz, Germany; 50 U/1 mL at each fat pad; n=30) or placebo (0.9% normal saline, 1 mL at each fat pad; n=30) injection into epicardial fat pads during surgery. Patients were followed for 1 year to assess maintenance of sinus rhythm using an implantable loop recorder. All patients in both groups had successful epicardial fat pad injections without complications. The incidence of early postoperative atrial fibrillation within 30 days after coronary artery bypass graft was 2 of 30 patients (7%) in the botulinum toxin group and 9 of 30 patients (30%) in the placebo group (P=0.024). Between 30 days and up to the 12-month follow-up examination, 7 of the 30 patients in the placebo group (27%) and none of the 30 patients in the botulinum toxin group (0%) had recurrent atrial fibrillation (P=0.002). There were no complications observed during the 1-year follow-up.

CONCLUSIONS:

Botulinum toxin injection into epicardial fat pads during coronary artery bypass graft provided substantial atrial tachyarrhythmia suppression both early as well as during 1-year follow-up, without any serious adverse events. CLINICAL TRIAL REGISTRATION URL http//www.clinicaltrials.gov. Unique identifier NCT01842529.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Doença da Artéria Coronariana / Ponte de Artéria Coronária / Toxinas Botulínicas Tipo A / Antiarrítmicos Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Circ Arrhythm Electrophysiol Ano de publicação: 2015 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Doença da Artéria Coronariana / Ponte de Artéria Coronária / Toxinas Botulínicas Tipo A / Antiarrítmicos Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Circ Arrhythm Electrophysiol Ano de publicação: 2015 Tipo de documento: Article