Implementing Prophylactic Amiodarone in Heart Surgery To Reduce Post -operative Atrial Fibrillation

Author

John M. Russell MSN, APN, FNP-BC, Illinois State UniversityFollow
Denise Wilson PhD, APN, FNP, CDE, Illinois State UniversityFollow

Date of Award

Summer 2016

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

Department

Mennonite College of Nursing

First Advisor

Denise Wilson, PhD, APN, FNP, CDE

Abstract

Purpose: The purpose of this project is to evaluate a practice change of implementing peri-operative amiodarone infusion for cardiac surgical patients at a large northern Illinois hospital to reduce the incidence of post-operative atrial fibrillation. Evidence supports use of prophylactic amiodarone as a strategy to reduce its incidence. The sequelae of untreated post-op atrial fibrillation include increased risk of embolic stroke, extended hospitalization, and increased healthcare costs.

Data Sources: The Society of Thoracic Surgeons (STS) Adult Cardiac Surgical Database is a validated research tool used to collect comprehensive data on its member surgeons. A pre/post intervention case-controlled retrospective study design was used and the hospital’s STS data was analyzed. Cardiac surgery patients from January 1 – June 30, 2015 who did not receive amiodarone and those from July 1 – December 31, 2015 who did were compared.

Conclusions: Post-op atrial fibrillation rates after cardiac surgery improved with the intervention, but were not statistically significant. Total incidence decreased from 17.9% to 8.3%. Isolated coronary artery bypass grafting patient incidence decreased from 15.4% to 5.4%, aortic valve surgery incidence decreased from 31.3% to 30.0%, and combination CABG and valve surgery decreased from 25% to 0%.

Implications for practice: Amiodarone is an effective way to reduce rates of post-op atrial fibrillation. When coupled with a beta-blocker regimen, further improvement is evident, although not statistically significant. Baseline rates below national average likely diminished the significance of this study; however, any effort to ameliorate post-op atrial fibrillation and the subsequent complications of its incidence should be taken.

Recommended Citation

Russell, John M. MSN, APN, FNP-BC and Wilson, Denise PhD, APN, FNP, CDE, "Implementing Prophylactic Amiodarone in Heart Surgery To Reduce Post -operative Atrial Fibrillation" (2016). Theses and Dissertations. 1423.
https://ir.library.illinoisstate.edu/etd/1423

DOI

http://doi.org/10.30707/ETD2016.Russell.J