Triiodothyronine therapy lowers the incidence of atrial fibrillation after cardiac operations.
Ann Thorac Surg
; 61(5): 1323-7; discussion 1328-9, 1996 May.
Article
in En
| MEDLINE
| ID: mdl-8633935
ABSTRACT
BACKGROUND:
Cardiopulmonary bypass results in a euthyroid sick state, and recent evidence suggests that perioperative triiodothyronine (T3) supplementation may have hemodynamic benefits. In light of the known effects of thyroid hormone on atrial electrophysiology, we investigated the effects of perioperative T3 supplementation on the incidence of postoperative arrhythmias.METHODS:
One hundred forty-two patients with depressed left ventricular function (ejection fraction < 0.40) undergoing coronary artery bypass grafting were randomized to either T3 or placebo treatment groups in a prospective, double-blind fashion. Triiodothyronine was administered as a 0.8 micrograms/kg intravenous bolus at the time of aortic cross-clamp removal followed by an infusion of 0.113 micrograms.kg-1.h-1 for 6 hours. Patients were monitored for the development of arrhythmias during the first 5 postoperative days.RESULTS:
The incidence of sinus tachycardia and ventricular arrhythmias were similar between groups. Triiodothyronine-treated patients had a lower incidence of atrial fibrillation (24% versus 46%; p = 0.009), and fewer required cardioversion (0 versus 6; p = 0.012) or anticoagulation (2 versus 10; p = 0.013) during hospitalization. Six patients in the T3 group versus 16 in the placebo group required antiarrhythmic therapy at discharge (p = 0.019).CONCLUSIONS:
Perioperative T3 administration decreased the incidence and need for treatment of postoperative atrial fibrillation.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Atrial Fibrillation
/
Triiodothyronine
/
Coronary Artery Bypass
Type of study:
Clinical_trials
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Ann Thorac Surg
Year:
1996
Document type:
Article
Affiliation country:
United States