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May 17, 2006

Prevention of Atrial Fibrillation Following Cardiac Surgery—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;295(19):2247-2248. doi:10.1001/jama.295.19.2248-a

In Reply: Dr Arias points out that obesity, as measured by body mass index, may be an independent predictor of postoperative atrial tachyarrhythmias after cardiac surgery. Unfortunately, because the study database did not include height, analyses based on body mass index cannot be provided. However, the database did include weight. The median weight of the PAPABEAR (Prophylactic Amiodarone for the Prevention of Arrhythmias that Begin Early After Revascularization, Valve Replacement, or Repair) patients was 84 kg (interquartile range, 75-96 kg). In patients randomized to placebo therapy, there was no difference in the probability of developing a postoperative atrial tachyarrhythmia in patients weighing more than 84 kg (28.2%) compared with those weighing 84 kg or less (29.9%). Similarly, comparing the hazard ratios (HRs) for atrial tachyarrhythmia in patients with amiodarone treatment and those with placebo, there was no significant difference between patients weighing more than 84 kg (HR, 0.40; 95% confidence interval [CI], 0.23-0.70) and patients weighing 84 kg or less (HR, 0.59; 95% CI, 0.37-0.95).