Prevention of Atrial Fibrillation Following Noncardiac Thoracic Surgery

NCT ID: NCT00127712

Last Updated: 2013-09-18

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

130 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-09-30

Study Completion Date

2008-02-29

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Atrial Fibrillation

Keywords

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amiodarone atrial fibrillation surgical procedures, thoracic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Amiodarone

Amiodarone 1050 mg via continuous intravenous infusion for 24 hours followed by 400 mg orally twice daily for 6 days

Group Type EXPERIMENTAL

Amiodarone

Intervention Type DRUG

No treatment

Patients in this group receive no intervention

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Amiodarone

Intervention Type DRUG

Eligibility Criteria

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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
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Purdue University

OTHER

Sponsor Role collaborator

Indiana University

OTHER

Sponsor Role lead

Responsible Party

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James E. Tisdale

Professor and Interim Head, Dept of Pharmacy Practice, Purdue University and Adjunct Professor, School of Medicine, Indiana University

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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James E Tisdale, PharmD

Role: PRINCIPAL_INVESTIGATOR

Department of Pharmacy Practice- School of Pharmacy and Pharmacal Sciences- Purdue University

Locations

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Indiana University

Indianapolis, Indiana, United States

Site Status

Countries

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United States

References

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Tisdale JE, Wroblewski HA, Wall DS, Rieger KM, Hammoud ZT, Young JV, Kesler KA. A randomized trial evaluating amiodarone for prevention of atrial fibrillation after pulmonary resection. Ann Thorac Surg. 2009 Sep;88(3):886-93; discussion 894-5. doi: 10.1016/j.athoracsur.2009.04.074.

Reference Type RESULT
PMID: 19699916 (View on PubMed)

Other Identifiers

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0407-16

Identifier Type: -

Identifier Source: org_study_id