PDF(Pubmed)
Abstract：
BACKGROUND: To evaluate the clinical efficacy and safety of intraoperative intravenous amiodarone for arrhythmia prevention in on-pump coronary artery bypass grafting (CABG) patients.
METHODS: A meta-analysis of randomized controlled trials was conducted. Pubmed, Embase, Cochrane Library, Ovid, China National Knowledge Infrastructure, and the Wan Fang database until July 1th, 2023. The primary outcomes of interest included the incidences of intra- and post-operative atrial fibrillation (POAF), ventricular fibrillation, or any arrhythmia, including atrial fibrillation, ventricular fibrillation, ventricular tachycardia, premature ventricular contraction, and sinus bradycardia. For continuous and dichotomous variables, treatment effects were calculated as the weighted mean difference (WMD)/risk ratio (RR) and 95% confidence interval (CI).
RESULTS: A database search yielded 7 randomized controlled trials including 608 patients, where three studies, including three treatments (amiodarone, lidocaine, and saline), contributed to the clinical outcome of atrial fibrillation, ventricular fibrillation, or any arrhythmia. Meta-analysis demonstrated that amiodarone can significantly reduce the incidence of POAF (RR, 0.39; 95%CI: 0.20, 0.77; P = 0.007, I2 = 0%) in patients undergoing on-pump CABG; there was no statistically significant influence on intra-operative atrial fibrillation, intra- and post-operative ventricular fibrillation, or any arrhythmia.
CONCLUSIONS: The current study suggests that intraoperative administration of intravenous amiodarone may be safe and effective in preventing POAF in patients undergoing on-pump CABG. More well-designed clinical trials are needed to validate this result.
METHODS: A meta-analysis of randomized controlled trials was conducted. Pubmed, Embase, Cochrane Library, Ovid, China National Knowledge Infrastructure, and the Wan Fang database until July 1th, 2023. The primary outcomes of interest included the incidences of intra- and post-operative atrial fibrillation (POAF), ventricular fibrillation, or any arrhythmia, including atrial fibrillation, ventricular fibrillation, ventricular tachycardia, premature ventricular contraction, and sinus bradycardia. For continuous and dichotomous variables, treatment effects were calculated as the weighted mean difference (WMD)/risk ratio (RR) and 95% confidence interval (CI).
RESULTS: A database search yielded 7 randomized controlled trials including 608 patients, where three studies, including three treatments (amiodarone, lidocaine, and saline), contributed to the clinical outcome of atrial fibrillation, ventricular fibrillation, or any arrhythmia. Meta-analysis demonstrated that amiodarone can significantly reduce the incidence of POAF (RR, 0.39; 95%CI: 0.20, 0.77; P = 0.007, I2 = 0%) in patients undergoing on-pump CABG; there was no statistically significant influence on intra-operative atrial fibrillation, intra- and post-operative ventricular fibrillation, or any arrhythmia.
CONCLUSIONS: The current study suggests that intraoperative administration of intravenous amiodarone may be safe and effective in preventing POAF in patients undergoing on-pump CABG. More well-designed clinical trials are needed to validate this result.
摘要：
背景：评估术中静脉注射胺碘酮预防体外循环冠状动脉旁路移植术（CABG）患者心律失常的临床疗效和安全性。
方法：对随机对照试验进行荟萃分析。Pubmed,Embase,科克伦图书馆,奥维德,中国国家知识基础设施，和万方数据库直到7月1日，2023年。感兴趣的主要结果包括术中和术后心房颤动（POAF）的发生率，心室纤颤,或任何心律失常，包括心房颤动,心室纤颤,室性心动过速,室性早搏,和窦性心动过缓.对于连续变量和二分变量，治疗效果以加权平均差(WMD)/风险比(RR)和95%置信区间(CI)计算.
结果：数据库搜索产生了7项随机对照试验，包括608名患者，其中三项研究，包括三种治疗(胺碘酮，利多卡因,和盐水)，有助于房颤的临床结果，心室纤颤,或任何心律失常。Meta分析显示胺碘酮能显著降低POAF的发生率(RR,0.39；95CI：0.20，0.77；P=0.007，I2=0％）在接受体外循环CABG的患者中；对术中房颤无统计学意义的影响，术中和术后心室纤颤,或任何心律失常。
结论：目前的研究表明，术中静脉注射胺碘酮可能是安全有效的预防体外循环CABG患者发生POAF的方法。需要更多精心设计的临床试验来验证这一结果。
方法：对随机对照试验进行荟萃分析。Pubmed,Embase,科克伦图书馆,奥维德,中国国家知识基础设施，和万方数据库直到7月1日，2023年。感兴趣的主要结果包括术中和术后心房颤动（POAF）的发生率，心室纤颤,或任何心律失常，包括心房颤动,心室纤颤,室性心动过速,室性早搏,和窦性心动过缓.对于连续变量和二分变量，治疗效果以加权平均差(WMD)/风险比(RR)和95%置信区间(CI)计算.
结果：数据库搜索产生了7项随机对照试验，包括608名患者，其中三项研究，包括三种治疗(胺碘酮，利多卡因,和盐水)，有助于房颤的临床结果，心室纤颤,或任何心律失常。Meta分析显示胺碘酮能显著降低POAF的发生率(RR,0.39；95CI：0.20，0.77；P=0.007，I2=0％）在接受体外循环CABG的患者中；对术中房颤无统计学意义的影响，术中和术后心室纤颤,或任何心律失常。
结论：目前的研究表明，术中静脉注射胺碘酮可能是安全有效的预防体外循环CABG患者发生POAF的方法。需要更多精心设计的临床试验来验证这一结果。
