Independent Effect of Digoxin in Preventing Atrial Fibrillation in High Risk Patients after CABG Surgery

Background: atrial fibrillation (af) is one of the most commonarrhythmias after coronary artery bypass graft (cabg)surgery. af can result in hemodynamic instability, thromboembolicevents, increase the perioperative myocardial infarction, congestive heart failure, stroke, more length of hospitalstay (lohs) and cost of treatment. the aim of this studywas to evaluate the independent effect of digoxin in preventingaf after cabg in patients who had a predictor for af andhad already been on other anti-arrhythmic drugs.methods: in a prospect ive randomized clinical trail, usingalternate randomization, 239 patients categorized into threedifferent groups. group one consisted of 72 patients whohad at least one predictor for developing af afte r cabg.group two consisted of 67 patients with the same predictorswho received 0.5 mg intravenous digoxin after disconnectingfrom bypass pump followed by 0.25 mg intravenousdigoxin one hour and four hours later. oral daily digoxin(0.25 mg) was continued from the first post operation dayto the 14th day with 2 days off per week. one hundred patientswithout those predictors for af were randomly allocatedin group three to confirm the impact of those predictorson developing af .results: af occurred in 16 patients (22.2%) in group 1, sixpatients (8.8%) in group 2, and seven patients (7%) in group 3.the duration of af was 6.43±4.23 min in group i,1.2±1.41 min in group 2, and 47.18±67.29 min in group 3.conclusion: intraoperative digoxin can independently decreasethe incidence of af after cabg surgery in patientswith high risk factors for af.