AATS: American Association for Thoracic Surgery.
Watch the AATS Leadership Video
 
Less Invasive and Highly Effective Method for Preventing Postoperative Atrial Fibrillation by the Intraoperative Application of a Novel Biodegradable Disc Containing Amiodarone
Takahide Takeda1, Takeshi Shimamoto2, Akira Marui1, Naritatu Saito3, Kyokun Uehara1, Tadashi Ikeda1, Ryuzo Sakata1;
1Department of cardiovascular surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; 2Department of cardiovascular surgery, Kurashiki Central Hospital, Kurashiki, Japan; 3Department of Cardiology, Nagai Hospital, Tsu, Japan
Objective: Atrial fibrillation (AF) is a common and undesirable complication after cardiac surgery. Amiodarone is a potent anti-AF agent; however, its systemic administration induces serious side-effects such as interstitial pneumonia. To avoid such systemic side effects, we develop a novel local sustained release system of amiodarone.
Methods: A biodegradable, cross-linkable dextran disc (10 mm of diameter) was developed as a sustained release carrier for amiodarone. Under general anesthesia, Japanese white rabbits underwent median sternotomy and the novel bio-disc containing amiodarone (30 mg) was implanted onto the surface of the right atrium. The disc without amiodarone was used as a control. After implantation, chest was closed. Three days after implantation, tissue concentrations of amiodarone were measured in the atria, ventricles, lungs, liver, thyroid, and the blood of the rabbits (n=5). Three days after implantation, AF threshold (AFT) and atrial effective refractory period (AERP) of the left atrium were measured using Langendorff apparatus. In addition, the incidence and duration of induced AF evoked by rapid pacing was measured and compared.
Results: The tissue concentrations of amiodarone in the atria, ventricles, lungs, liver, and thyroid were 827 ± 381, 10.5 ± 8.1, 1.8 ± 1.1, 1.3 ± 0.5, and 7.9 ± 7.3, respectively. The atrial concentration of amiodarone was far higher than those of the other organs (p<0.001, respectively). The blood concentration of amiodarone was under detection. The bio-disc containing amiodarone significantly increased the AFT (6.9 ± 4.6 mA for the amiodarone group, vs. 0.46 ± 0.63 mA for the control group, p=0.0007) and ERP (53.9 ± 8.9 ms for the amiodarone group vs. 43.9 ± 9.5 ms for the control group, p=0.035) of the left atrium, which indicates that bio-disc containing amiodarone had pharmacological effect on left atrium, and significantly reduced the threshold of inducing AF. As for the duration and the frequency of AF, in 5mA and 10mA stimulus the amiodarone group significantly kept low and less likely to induce AF compared with the control group. (P<0.05)
Conclusion: A novel biodegradable disc containing amiodarone is easily applicable and maintained effective atrial concentration without the elevation of other tissue or the blood concentration. This approach may be less invasive and highly effective therapeutic option to prevent postoperative AF.

Back to 2010 Annual Meeting
Back to Program Outline
Back to Main Program
Policies | Find a Surgeon | About | Contact
We Model Excellence
 Follow AATS on Facebook
Copyright © American Association for Thoracic Surgery. All rights reserved.
Read the Privacy Policy.
IMPORTANT REMINDER: The preceding information is intended only to provide
general guidance and not as a definitive basis for diagnosis or treatment in any particular case.
It is very important that you consult a doctor about any specific medical problem or question.