Comparison Between Effects of Amiodarone vs. Nebivolol in Treating Atrial Fibrillation Following Coronary Artery Bypass Grafting

Ashraf  El-Nahas; Yousry  Rezk; Basem Aglan; Hossam  Amer; Ihab Omar

Ashraf El-Nahas Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Yousry Rezk Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Basem Aglan Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Hossam Amer Critical Care Department, Mahalla Cardiac Center, Mahalla, Egypt
Ihab Omar Department of Cardiothoracic Surgery, Faculty of Medicine, Beni-Suef University, Egypt

Keywords: Amiodarone, Nebivolol, Atrial Fibrillation, Coronary Artery Bypass Grafting

Abstract

Background: Atrial fibrillation (AF) is the most prevalent type of arrhythmia following cardiac surgery. Several agents are used for managing postoperative AF, but their efficacy is controversial. This study evaluated the effectiveness of amiodarone versus nebivolol in treating postoperative AF.

Methods: This randomized trial was conducted from November 2022 to November 2023 and involved 100 patients who developed postoperative AF after coronary artery bypass grafting. Patients were divided into two groups: Group A (n=50) received amiodarone, and Group B (n=50) received nebivolol.

Results: Compared with Group B, Group A had a significantly longer aortic clamp time [60.9 ± 11.27 vs. 55.6 ± 10.18 min; p value= 0.051]. Moreover, the total cardiopulmonary bypass time did not significantly differ between the two groups [89.62 ± 19.76 vs. 92.44 ± 17.74 min; p value= 0.455]. Compared with Group B, sinus rhythm control in Group A was notably better at 6 hours (16% vs. 2%), 12 hours (44% vs. 12%), 24 hours (62% vs. 16%), 48 hours (83.3% vs. 17%), and 72 hours (100% vs. 25.5%) postintervention (p < 0.001). However, no significant difference was observed in the effect of either drug on the rate control at these intervals. Moreover, the morbidity and mortality rates were not significantly different between the two groups.

Conclusion: Amiodarone might be superior to nebivolol in the treatment of postoperative AF following coronary artery bypass grafting. Amiodarone could be the treatment of choice for postoperative AF after CABG.