Mark F Berry1, Thomas A D'Amico2, Mark W Onaitis2. 1. Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address: berry037@mc.duke.edu. 2. Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.
Abstract
BACKGROUND: We evaluated the association of respiratory complications and amiodarone use in patients with atrial fibrillation (AF) after major lung resection. METHODS: Outcomes of patients who had postoperative AF treated with or without amiodarone after lobectomy, bilobectomy, or pneumonectomy at a single institution between 2003 and 2010 were evaluated using multivariable logistic modeling. RESULTS: Of 1,412 patients who underwent lobectomy, bilobectomy, or pneumonectomy, AF occurred in 232 (16%). Atrial fibrillation developed after a respiratory complication in 31 patients, who were excluded from subsequent analysis. The remaining 201 patients who had AF without an antecedent respiratory complication had similar mortality (3.0% [6 of 201] vs 2.5% [30 of 1,180], p = 0.6) and respiratory morbidity (10% [20 of 201] vs 9% [101 of 1,180], p = 0.5) but longer hospital stays (5 [4 to 7] vs 4 days [3 to 6], p < 0.0001) compared with the 1,180 patients who did not have AF. Amiodarone was used in 101 (50%) of these 201 patients, including 5 patients who had a pneumonectomy. Age, pulmonary function, and operative resection were similar between the patients treated with and without amiodarone. Amiodarone use was not associated with a significant difference in the incidence of subsequent respiratory complications (12% [12 of 101 amiodarone patients] vs 8% [8 of 100 non-amiodarone patients], p = 0.5). CONCLUSIONS: Atrial fibrillation that occurs without an antecedent respiratory complication in patients after major lung resection results in longer hospital stay but not increased mortality or respiratory morbidity. Using amiodarone to treat atrial fibrillation after major lung resection is not associated with an increased incidence of respiratory complications.
BACKGROUND: We evaluated the association of respiratory complications and amiodarone use in patients with atrial fibrillation (AF) after major lung resection. METHODS: Outcomes of patients who had postoperative AF treated with or without amiodarone after lobectomy, bilobectomy, or pneumonectomy at a single institution between 2003 and 2010 were evaluated using multivariable logistic modeling. RESULTS: Of 1,412 patients who underwent lobectomy, bilobectomy, or pneumonectomy, AF occurred in 232 (16%). Atrial fibrillation developed after a respiratory complication in 31 patients, who were excluded from subsequent analysis. The remaining 201 patients who had AF without an antecedent respiratory complication had similar mortality (3.0% [6 of 201] vs 2.5% [30 of 1,180], p = 0.6) and respiratory morbidity (10% [20 of 201] vs 9% [101 of 1,180], p = 0.5) but longer hospital stays (5 [4 to 7] vs 4 days [3 to 6], p < 0.0001) compared with the 1,180 patients who did not have AF. Amiodarone was used in 101 (50%) of these 201 patients, including 5 patients who had a pneumonectomy. Age, pulmonary function, and operative resection were similar between the patients treated with and without amiodarone. Amiodarone use was not associated with a significant difference in the incidence of subsequent respiratory complications (12% [12 of 101 amiodaronepatients] vs 8% [8 of 100 non-amiodaronepatients], p = 0.5). CONCLUSIONS:Atrial fibrillation that occurs without an antecedent respiratory complication in patients after major lung resection results in longer hospital stay but not increased mortality or respiratory morbidity. Using amiodarone to treat atrial fibrillation after major lung resection is not associated with an increased incidence of respiratory complications.
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