Atrial Fibrillation Clinical Trial
Official title:
Prevention of Atrial Fibrillation Following Thoracoabdominal Esophagectomy Surgery
The investigators hypothesize that the medication amiodarone decreases the incidence of
atrial fibrillation (AF) following esophagectomy surgery. Their specific aims are to:
Determine the effectiveness of amiodarone for the prevention of AF following esophagectomy
surgery; Determine the influence of the prevention of AF following esophagectomy surgery on
post-surgical duration of stay in the Intensive Care Unit ICU)and duration of post-surgical
hospital stay; and Determine the safety of amiodarone for the prevention of AF following
esophagectomy surgery.
Thousands of patients undergo major esophagectomy surgery in the United States each year,
during which all or a portion of the esophagus is removed. A major complication of these
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
esophagectomy 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
esophagectomy is significantly higher in patients who develop AF compared with those who do
not. Therefore, the occurrence of this irregular heartbeat following esophagectomy 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 esophagectomy has not been well studied,
and amiodarone has not been studied in a controlled trial for the prevention of AF in this
population. 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.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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