Research article

Does prophylactic sotalol and magnesium decrease the incidence of atrial fibrillation following coronary artery bypass surgery: a propensity-matched analysis

V Aerra¹ , M Kuduvalli¹ , AN Moloto¹ , AK Srinivasan¹ , AD Grayson^2,3 , BM Fabri¹ and AY Oo¹

¹  Department of Cardiothoracic Surgery. The Cardiothoracic Centre Liverpool, UK

²  Department of Research and Development. The Cardiothoracic Centre Liverpool, UK

³  Senior Clinical Information Analyst, Clinical Governance Department. The Cardiothoracic Centre-Liverpool, Thomas Drive, Liverpool, L14 3PE, UK

author email corresponding author email

Journal of Cardiothoracic Surgery 2006, 1:6doi:10.1186/1749-8090-1-6

Published:	3 March 2006

Abstract

Background

Atrial fibrillation can occur in up to 40% of patients undergoing coronary surgery.

Methods

We retrospectively analysed 103 consecutive coronary surgery patients under the care of one surgeon between April 2003 and September 2003. These patients received 40 mg of sotalol orally twice daily from the first post-operative day for 6 weeks and 2 g of magnesium intravenously immediately post surgery and on the first post-operative day. We developed a propensity score for the probability of receiving sotalol and magnesium after coronary surgery. 89 patients from the sotalol and magnesium group were successfully matched with 89 unique coronary surgery patients who did not receive either sotalol or magnesium with an identical propensity score.

Results

Preoperative characteristics were well matched between groups. There was no significant difference with respect to in-hospital mortality between groups (sotalol and magnesium 1.1% versus control 4.5%; p = 0.17). The incidence of atrial fibrillation in the sotalol and magnesium group was 13.5% compared to 27.0% in the controls (p = 0.025).

Conclusion

The combination of sotalol and magnesium can significantly reduce the incidence of post-operative atrial fibrillation following coronary surgery.