World Cardiology Conference 2026

Abstract

Background: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, often leading to extended hospital stays and a higher risk of post-operative complications, including stroke and heart failure. Amiodarone, a class III antiarrhythmic agent, has been shown to aid in the maintenance of sinus rhythm after surgery. While its benefits are well-established in traditional open-heart surgeries (e.g., coronary artery bypass grafting [CABG]), its efficacy in minimally invasive cardiac procedures had not been conclusively determined. However, recent clinical trials involving minimally invasive surgeries have since been conducted. This review aims to reassess the efficacy of prophylactic amiodarone by incorporating findings from these new studies, potentially providing further insight into its clinical benefits.

Methods: A comprehensive search of PubMed, Google Scholar, EMBASE, and the Cochrane Library was conducted. Studies were included based on the PICO framework, focusing on amiodarone’s impact on preventing postoperative atrial fibrillation. Primary outcomes were the incidence of POAF and hospital stay duration.

Results: Ten studies met the inclusion criteria, with seven focusing on the use of amiodarone in open cardiac surgeries and three in minimally invasive procedures. Collectively, these studies involved 18,822 patients undergoing various types of cardiac surgery. Administration of oral amiodarone (200mg) reduced the incidence of POAF by 45% (Risk ratio: 0.55, p=0.002) and reduced hospital stays by 1.2 days (Hazard ratio: 1.52, p=0.04) compared to placebo. Similarly, intravenous amiodarone reduced the incidence of POAF by 42% (Risk ratio: 0.58, p = 0.02) and hospital stay duration by 1.5 days (Hazard ratio: 1.46, p = 0.018).

Conclusion: Prophylactic amiodarone shows promise in reducing POAF incidence and hospital stay durations following cardiac surgeries. The incorporation of the recent studies in minimally invasive cardiac procedures further supports these findings. Integrating amiodarone into perioperative care protocols may enhance patient outcomes and help lower healthcare costs.