چكيده لاتين :
Background: Atrial fibrillation (AF) is one of the most common
arrhythmias after coronary artery bypass graft (CABG)
surgery. AF can result in hemodynamic instability, thromboembolic
events, increase the perioperative myocardial infarction
, congestive heart failure, stroke, more length of hospital
stay (LOHS) and cost of treatment. The aim of this study
was to evaluate the independent effect of digoxin in preventing
AF after CABG in patients who had a predictor for AF and
had already been on other anti-arrhythmic drugs.
Methods: In a prospect ive randomized clinical trail, using
alternate randomization, 239 patients categorized into three
different groups. Group one consisted of 72 patients who
had at least one predictor for developing AF afte r CABG.
Group two consisted of 67 patients with the same predictors
who received 0.5 mg intravenous digoxin after disconnecting
from bypass pump followed by 0.25 mg intravenous
digoxin one hour and four hours later. Oral daily digoxin
(0.25 mg) was continued from the first post operation day
to the 14th day with 2 days off per week. One hundred patients
without those predictors for AF were randomly allocated
in group three to confirm the impact of those predictors
on developing AF .
Results: AF occurred in 16 patients (22.2%) in group 1, six
patients (8.8%) in group 2, and seven patients (7%) in group 3.
The duration of AF was 6.43±4.23 min in group I,
1.2±1.41 min in group 2, and 47.18±67.29 min in group 3.
Conclusion: Intraoperative digoxin can independently decrease
the incidence of AF after CABG surgery in patients
with high risk factors for AF.
