Pragmatic Amiodarone Trial to Reduce Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery

Operative mortality

Operative mortality as defined by either in-hospital death or death within 30 days of discharge.

Time frame: Either in-hospital or within 30 days of procedure

Stroke

characterized by deficits lasting \> 24 hours and/or imaging findings of infarction

Time frame: Either in-hospital or within 30 days of procedure

Transient ischemic attack

characterized by examination findings lasting \< 24 hours without associated imaging findings

Time frame: Either in-hospital or within 30 days of procedure

Electrical cardioversion

Whether the patient required electrical cardioversion for hemodynamically unstable atrial fibrillation

Time frame: Either in-hospital or within 30 days of procedure

Hemodynamic instability

New hemodynamic instability (mean arterial pressure \< 65 mmHg) after surgery

Time frame: Either in-hospital or within 30 days of procedure

Initiation of systemic anticoagulation

New indication of systemic anticoagulation for stroke prophylaxis due to atrial fibrillation

Time frame: Either in-hospital or within 30 days of procedure

Myocardial infarction

Myocardial infarction diagnosed based on ECG and laboratory testing including pursued intervention and/or findings from subsequent angiography will be compared between intervention groups. To be considered a myocardial infarction, the diagnosis will have to be confirmed and documented in the chart by a board-certified cardiologist.

Time frame: Either in-hospital or within 30 days of procedure

Persistence of atrial fibrillation at discharge

Atrial fibrillation as diagnosed by final ECG

Time frame: Up to 90 days

Postoperative hospital length of stay

The postoperative length of stay will be calculated starting from the end of the procedure to time of discharge.

Time frame: Up to 90 days

Readmission

Rates of hospital readmission will be estimated for patients in each of the study intervention groups. Readmissions will be counted in this calculation if patients are admitted to the hospital. Emergency room visits without admission and outpatient visits will not count toward this calculation of readmission rates.

Time frame: Within 30 days of procedure

Symptomatic bradycardia

Symptomatic bradycardia (HR \< 55 bpm) requiring intervention

Time frame: Either in-hospital or within 30 days of procedure

Number of patients with Amiodarone-related pulmonary toxicity

Clinical diagnosis of amiodarone-related pulmonary toxicity that uses a combination of x-ray findings consistent with known amiodarone-related pulmonary toxicity and clinical findings including shortness of breath, non-productive cough, and other diagnoses have been excluded.

Time frame: Either in-hospital or within 30 days of procedure