Treatment of Arrhythmias: Pharmacologic

November 16, 2009
Chris Cole

This all-day abstract poster session featured researchers presenting results of studies focused on such topics as atrial fibrillation following pulmonary transplantation, use of Digoxin in atrial fibrillation, supplementation of Omega 3 PUFA plus antioxidante vitamins to prevent postoperative atrial fibrillation, and the impact of hypothyroidism on atrial fibrillation treatment strategy outcomes. The results are highlighted here.

This all-day abstract poster session featured researchers presenting results of studies focused on such topics as atrial fibrillation following pulmonary transplantation, use of Digoxin in atrial fibrillation, supplementation of Omega 3 PUFA plus antioxidante vitamins to prevent postoperative atrial fibrillation, and the impact of hypothyroidism on atrial fibrillation treatment strategy outcomes. The results are highlighted here.

Atrial Fibrillation Following Pulmonary Transplantation: Incidence, Treatment, and Short Term OutcomesGenevieve Giraldeau, Christine Henri, Marc Dorais, Alexis-Simon Cloutier, Pasquale Ferraro, and Stephane Rinfret, CHUM Research Center, Montreal, Quebec, Canada

This research was conducted to better understand the incidence, ideal therapeutic approaches, and in-hospital complications associated with atrial fibrillation (AF) in patients following lung transplantation, as it is a common complication among this population, whom present fewer established risk factors for post-operative AF. Giraldeau's team found that AF was indeed fairly common following lung transplantation, that complications were transient and benign overall, and that current pharmacologic treatments appear to be effective. Additionally, Giraldeau noted that although heparin was used infrequently, ischemic strokes were rare, with most patients returning to sinus rhythm before discharge.

Digoxin in Atrial Fibrillation - From the Stockholm Cohort-study of Atrial Fibrillation (SCAF)Leif Friberg, Niklas Hammar, Marten Rosenqvist, Karolinska Institute, Stockholm, Sweden

With recent studies "of patients with heart failure and of patients in intensive care unites" indicating that Digoxin "may increase mortality if the patient has atrial fibrillation" (AF), and the "applicability of these findings to common" AF patients unclear, Friberg, et al. sought to study what patients were administered Digoxin treatment for AF and what their prognosis would be. They determined that the increased mortality associated with Digoxin use is due to the fact that the drug is mainly administered to older and frailer patients with AF, and that when these differences are accounted for, along with others, the drug appears to be "neutral visavi long term mortality and major cardiovascular events in AF patients."

Prevention of Postoperative Atrial Fibrillation with the Supplementation of Omega 3 PUFA Plus Antioxidant Vitamins in Patients Undergoing Cardiac Surgery with Extracorporeal CirculationMauricio Cereceda, Ramon Rodrigo, Rodrigo Castillo, Rodrigo Pizarro, Rene Asenjo, Jaime Zamorano, Julia Araya, Rodrigo Castillo-Koch, Juan Espinoza, and Luigi Laggazzi, University of Chile, Santiago, Chile

With omega 3 polyunsaturated fatty acids (PUFA) shown to enhance antioxidant enzymes in experimental models, "an effect likely to protect against oxidative challenges of myocardium," and a belief that supplementation "with antioxidant vitamins C and E would further reinforce the antioxidant" defenses, Cereceda and colleagues randomized 83 patients who were scheduled for cardiac surgery with extracorporeal circulation to placebo or supplementation with omega 3 PUFA followed by vitamin C and vitamin E from 7, 2, and 2 days prior to surgery, respectively. They determined that omega 3 PUFA supplementation plus antioxidant vitamins "attenuates the myocardial biochemical and functional injury and markedly decreases the occurrence of postoperative atrial fibrillation."

Impact of Hypothyroidism on Outcomes of Atrial Fibrillation Treatment StrategiesApril Slee and Snehal Rathod, Electrophysiology Research Foundation, Warren, NJ; and Sanjeev Saksena, UMDNJ - Robert Wood Johnson Medical School, New Brunswick ,NJ

In order to determine if hypothyroidism coexists with atrial fibrillation (AF) or is due to amiodarone therapy in AF and what its impact is on mortality and hospitalization events, this research team "compared a composite mortality & hospitalization endpoint for assessment of outcomes in AF pts who were randomized to either amiodarone or a rate control strategy (Rate) in the AFFIRM trial." Slee and colleagues found that elderly and female patients were most likely to suffer from thyroid abnormalities and that despite replacement thyroid hormone therapy, patients who are treated with amiodarone therapy can expect their thyroid disease to adversely impact cardiovascular outcomes.