Epicardial botulinum toxin injection was associated with "a numerically lower risk of postoperative atrial fibrillation (AFib)," in coronary artery bypass grafting (CABG) patients, according to results from the TNT-POAF trial presented Nov. 15 at AHA 2017 in Anaheim, CA.

Nathan H. Waldron, MD, MHS, et al., looked at 130 patients undergoing CABG, valve surgery, or CABG plus valve surgery who were randomized to receive an injection of botulinum toxin (250 units) or normal saline (5mL) in 5 epicardial fat pads.

Results showed that epicardial botulinum toxin injection was associated with "a numerically lower risk of postoperative AFib," however this difference "did not reach statistical significance."

Further, epicardial botulinum treatment was not associated with an increase in adverse events, duration of postoperative mechanical ventilation, or length of stay vs. normal saline.

The researchers explain "these data indicate that epicardial botulinum may be a viable strategy to prevent postoperative AFib prevention and should be studied in a larger-scale trial."

"The small study size and lack of statistical significance between treatment groups suggest that a much larger study is needed," commented Kim A. Eagle, MD, MACC, editor-in-chief of ACC.org.

Keywords: AHA17, AHA Annual Scientific Sessions, Atrial Fibrillation, Trinitrotoluene, Postoperative Period, Cardiovascular Diseases, Coronary Artery Bypass

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