Amiodarone and N-Acetylcysteine or Amiodarone Alone for Preventing Atrial Fibrillation After Thoracic Surgery
Amiodarone and N-Acetylcysteine or Amiodarone Alone for Preventing Atrial Fibrillation After Thoracic Surgery
This trial will be comparing the combination of amiodarone and NAC (n=122) to amiodarone
 alone and NAC matched placebo (n=122) to determine the rates with which sustained (lasting
 >30 seconds) or clinically significant POAF is reduced in high risk patients within 7 days
 after major thoracic surgery.
Inclusion Criteria:

 -  Patients ≥18 years old scheduled for elective thoracic surgery (segmentectomy,
 lobectomy or bi-lobectomy, pneumonectomy or esophagectomy) and meeting one of the four
 following risk criteria:

 -  1. Female & BNP ≥ 25pg/ml (no age limit)

 -  2. Male gender <75 & BNP ≥ 25pg/ml

 -  3. Male- age ≥75 (No BNP limit)

 -  4. History of prior AF

 -  Patients in sinus rhythm.

 -  Patients with stable respiratory status (no respiratory distress).

 -  Patients capable of providing written, informed consent.

 Exclusion Criteria:

 -  Patients scheduled for extrapleural pneumonectomy.

 -  Hemodynamically unstable patients (not in cardiogenic shock or having an acute MI).

 -  Patients with 2nd or 3rd degree atrioventricular (AV) block.

 -  Patients with hypersensitivity to amiodarone or NAC.

 -  Patients already taking class Ic or III antiarrhythmic drugs.

 -  Hepatic insufficiency (≤2 times the upper normal limit of transaminase levels).

 -  Renal insufficiency (creatinine ≥2.0 mg/dl).

 -  Known pregnancy.