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Prevention of Atrial Fibrillation Following Noncardiac Thoracic Surgery

Information source: Indiana University
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Atrial Fibrillation

Intervention: Amiodarone (Drug)

Phase: Phase 4

Status: Completed

Sponsored by: Indiana University

Official(s) and/or principal investigator(s):
James E Tisdale, PharmD, Principal Investigator, Affiliation: Department of Pharmacy Practice- School of Pharmacy and Pharmacal Sciences- Purdue University

Summary

The investigators hypothesize that the medication amiodarone decreases the incidence of atrial fibrillation (AF) following non-cardiac open-chest surgery. Their specific aims are to:

- Determine the effectiveness of amiodarone for the prevention of AF following

non-cardiac open-chest surgery;

- Determine the influence of the prevention of AF following non-cardiac thoracic surgery

on post-surgical duration of stay in the Intensive Care Unit (ICU); post-surgical duration of stay in a hospital unit that employs cardiac monitoring; and duration of post-surgical hospital stay; and

- Determine the safety of amiodarone for the prevention of AF following non-cardiac

open-chest surgery.

Clinical Details

Official title: Prevention of Atrial Fibrillation Following Noncardiac Thoracic Surgery

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Primary outcome:

Incidence of Atrial Fibrillation Requiring Treatment

Incidence of Atrial Fibrillation Lasting Longer Than 30 Seconds

Secondary outcome:

Length of Intensive Care Unit Stay

Length of Hospital Stay

Detailed description: Thousands of patients undergo major non-cardiac open-chest surgery in the United States each year. These surgeries most often consist of lung surgery, in which one lobe of the lung is removed (lobectomy) or the entire lung is removed (pneumonectomy). A major complication of these non-cardiac open-chest surgeries is the occurrence of an irregular heartbeat known as atrial fibrillation (AF), which develops in up to 40% of patients undergoing these procedures. AF is characterized by rapid, irregular, chaotic beating of the two smaller chambers of the heart (the atria), leading to rapid, irregular beating of the two larger chambers (the ventricles). The average time to occurrence of post-surgical AF is 2-3 days following surgery. AF occurring following major non-cardiac open-chest surgery can result in extremely rapid heart rates, as fast as 150-200 beats per minute, and may be associated with serious consequences, including severely low blood pressure and potentially debilitating stroke. Further, the risk of death following non-cardiac open-chest surgery is significantly higher in patients who develop AF compared with those who do not. Therefore, the occurrence of this irregular heartbeat following non-cardiac open-chest surgery is associated with severe, potentially life-threatening consequences. Prevention of this irregular heartbeat in these patients may therefore be very important. Amiodarone is a medication that is known to be effective for prevention and treatment of AF that occurs in patients who have not undergone surgery. In addition, amiodarone has been shown to be effective for prevention of AF following open-chest heart surgery. However, the use of medications for prevention of AF following non-cardiac open-chest surgery has not been well studied, and amiodarone has not been studied in a controlled trial for the prevention of AF in patients undergoing these procedures. In addition, amiodarone is associated with side effects, and it is important to determine the safety of this medication when used in this patient population.

Eligibility

Minimum age: 40 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Males or females over the age of 40

- Scheduled to undergo pneumonectomy or lobectomy

Exclusion Criteria:

- History (hx) of atrial fibrillation

- Prior severe side effects from amiodarone

- Elevated liver enzymes >3 times the upper limit of normal (UNL)

- QTc interval > 450 ms

- Receiving class Ia or class III antiarrhythmics

Locations and Contacts

Indiana University, Indianapolis, Indiana 46202, United States
Additional Information

Starting date: September 2004
Last updated: September 6, 2013

Page last updated: August 23, 2015

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