Using Rapid Atrial Pacing During First-Time Open-Heart Surgery to Prevent Postoperative Atrial Fibrillation with Amiodarone Treatment

What this Trial Is About

Researchers are studying patients undergoing their first cardiac surgery to see if rapid atrial pacing during surgery can predict the development of postoperative atrial fibrillation POAF. The trial evaluates whether using this pacing test to identify patients who may benefit from preventive treatment with amiodarone can reduce the occurrence of AF after surgery. This phase 4 study aims to improve how doctors manage the risk of AF following heart operations. During surgery, the surgeon will briefly stimulate the upper right part of the heart with a pacemaker for 30 seconds before starting heart-lung bypass. If this causes atrial fibrillation lasting at least 30 seconds, patients are randomly assigned to receive either preventive amiodarone treatment or no initial drug treatment. Those without induced AF receive standard postoperative care. Amiodarone is given starting with an intravenous dose during surgery followed by continuous IV infusion and then oral doses until discharge. Participants will be closely monitored after surgery to track if they develop AF and to assess how well the test predicts this condition. The main outcome measured is the reduction in new AF episodes within 30 days after surgery. The study includes heart rhythm monitoring, documentation of treatment effects, and routine follow-up until hospital discharge and beyond. Overall participation involves the surgical procedure, drug administration if assigned, and postoperative observation.

Prevention of Postop Atrial Fibrillation Through Intraoperative Inducibility of Atrial Fibrillation and Amiodarone Treatment