Botox helps prevent atrial fibrillation following bypass surgery

by Bruce Sylvester: Botox injection into fat surrounding the heart helps prevent atrial fibrillation after bypass surgery, researchers reported  on Oct. 20, 2015 in Circulation: Arrhythmia and Electrophysiology.

“This first-in-man study has opened a whole new line of thinking and research,” said lead author Jonathan Steinberg, M.D., Adjunct Professor of Medicine at the University of Rochester in Rochester New York and Director of the Arrhythmia Institute in the Valley Health System in Ridgewood, New Jersey.

As background, Steinberg noted that approximately a third of all bypass surgery patients will develop atrial fibrillation, increasing risks of cardiovascular complications. “Atrial fibrillation is also always associated with lengthened hospitalization and that means increased healthcare costs,” he added.

Researchers at two Russian hospitals randomized 60 patients to receive Botox or placebo saline injections in the four major fat pads around the heart. Neither patients nor clinicians knew the identity of those who received Botox and who received placebo.

The investigators reported that during 30 days following surgery, the Botox-treated subjects had a 7 percent rate of ensuing atrial fibrillation, compared to 30 percent among the placebo-treated subjects.

At 12 months, none of the Botox-treated subjects had ongoing atrial fibrillation, compared to 27 percent of the placebo-treated subjects.

There were no reported Botox-related complications, and complications from bypass surgery were similar in both groups.

The authors emphasized that their results must be replicated in larger studies. “In the near future, Botox injections may become the standard of care for heart bypass and valve patients, but we’re not quite there yet,” Steinberg said.

The Russian State Research Institute of Circulation Pathology and the Siberian Division of Russian Academy of Medical Sciences funded the study.