Verapamil as prophylactic treatment for atrial fibrillation after lung operations.

Abstract

BACKGROUND:

Atrial fibrillation is a frequently occurring arrhythmia after thoracic operations. Preventive strategies for this complication have been extensively evaluated after cardiac operations.

METHODS:

We performed a prospective, open randomized study, comparing intravenous verapamil and placebo in 199 patients after pneumonectomy or lobectomy at the University Hospital of Leuven. Verapamil was administered as a bolus of 10 mg over 2 minutes followed by a 30-minute infusion of 0.375 mg/min and then 0.125 mg/min for 3 days. The patients were continuously monitored in the postoperative intensive care unit.

RESULTS:

Atrial fibrillation occurred in 15% of the patients receiving placebo and in 8% of the patients receiving verapamil (difference not significant). The verapamil infusion was interrupted in 9% of the patients because of bradycardia and in 14% because of hypotension.

CONCLUSIONS:

If tolerated, continuous intravenous verapamil infusion showed only a modest prophylactic efficacy for the occurrence of atrial fibrillation after lung operations. In the dose employed the verapamil infusion was accompanied with a high incidence of side effects necessitating interruption of the therapy.

• Authors: W Van Mieghem, G Tits, K Demuynck, L Lacquet, G Deneffe, T Tjandra-Maga, M Demedts
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 61 Issue 4 Pg. 1083-5; discussion 1086 (Apr 1996) ISSN: 0003-4975 [Print] Netherlands
• PMID: 8607661 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Arrhythmia Agents
• Verapamil
• Amiodarone

Topics

• Amiodarone (adverse effects, therapeutic use)
• Anti-Arrhythmia Agents (adverse effects, blood, therapeutic use)
• Atrial Fibrillation (epidemiology, etiology, prevention & control)
• Bradycardia (chemically induced, epidemiology)
• Humans
• Hypotension (chemically induced, epidemiology)
• Incidence
• Middle Aged
• Pneumonectomy (adverse effects, statistics & numerical data)
• Postoperative Complications (epidemiology, etiology, prevention & control)
• Prospective Studies
• Respiratory Distress Syndrome (chemically induced, epidemiology)
• Verapamil (adverse effects, blood, therapeutic use)