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Intravenous to Oral Transition of Amiodarone (IOTA): Effect of Various Durations of Overlap on Atrial Fibrillation Recurrence After Cardiothoracic Surgery.
Lam, Jade C; Stevenson, Byron; Lee, Yong Gu; Maurer, Jennifer; Patanwala, Asad E; Radosevich, John J.
Afiliação
  • Lam JC; Department of Pharmacy, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.
  • Stevenson B; Department of Pharmacy, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.
  • Lee YG; Department of Pharmacy, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.
  • Maurer J; Department of Pharmacy, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.
  • Patanwala AE; Department of Pharmacy, Faculty of Medicine and Health, University of Sydney, Royal Prince Alfred Hospital, Sydney.
  • Radosevich JJ; Department of Pharmacy, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.
J Cardiovasc Pharmacol ; 79(6): 808-814, 2022 06 01.
Article em En | MEDLINE | ID: mdl-35170491
ABSTRACT: The use of amiodarone for postoperative atrial fibrillation (AF) is widespread; however, there is a paucity of data on the optimal duration of overlap when transitioning from intravenous (IV) to oral amiodarone. The objective of this study was to evaluate the safety and efficacy of varying durations of overlap when amiodarone IV infusion is transitioned to oral administration in cardiothoracic surgery patients. This retrospective, observational, single-center study included cardiothoracic surgery patients who were initiated on IV amiodarone for supraventricular arrhythmia and subsequently transitioned to oral amiodarone. The primary outcome was AF recurrence within 24 hours after IV amiodarone discontinuation. Safety outcomes include occurrence of bradycardia or hypotension while on amiodarone. A total of 184 patients were included for analysis. AF recurrence occurred in 24.5% of patients (n = 45). No significant association was found between various overlap durations and AF recurrence (odds ratio (OR) 1.00, 95% CI 1.00-1.01, P = 0.9). In addition, no significant association was found between duration of overlap and rates of bradycardia (OR 1.00, 95% confidence interval (CI) 0.99-1.00, P = 0.08) or hypotension (OR 1.00, 95% CI 0.99-1.00, P = 0.21), which occurred in 35.9% and 47.3% of patients, respectively. Our study suggests following conversion to normal sinus rhythm; cardiothoracic surgery patients can effectively and safely be transitioned from IV to oral amiodarone without the need for specific overlap duration or transition strategy.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Amiodarona / Hipotensão Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Amiodarona / Hipotensão Idioma: En Ano de publicação: 2022 Tipo de documento: Article