Botox Injected During Coronary Surgery Reduced Atrial Fibrillation and Hospitalizations

MedicalResearch.com Interview with:

Jonathan S. Steinberg, MD Director, SMG Arrhythmia Center Summit Medical Group Professor of Medicine (adj) University of Rochester School of Medicine Core Professor of Cardiology and Internal Medicine Hackensack Meridian School of Medicine at Seton Hall U Short Hills, NJ 07078

Dr. Steinberg

Jonathan S. Steinberg, MD
Director, SMG Arrhythmia Center
Summit Medical Group
Professor of Medicine (adj)
University of Rochester School of Medicine
Core Professor of Cardiology and Internal Medicine
Hackensack Meridian School of Medicine at Seton Hall U
Short Hills, NJ 0707

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The autonomic nervous system activity plays an important role in the onset and perpetuation of atrial fibrillation, particularly for AF that follows cardiac surgery.

Botulinum toxin (BTX) is a potent inhibitor of neural transmission. In a randomized placebo-controlled study of 60 patients undergoing coronary artery bypass graft surgery, patients who received intraoperative Botulinum toxin injections to the neural ganglia on the cardiac surface exhibited a sustained reduction in the incidence and overall burden of atrial fibrillation (AF) over 3 years of follow-up, accompanied by a reduction in need for hospitalization.

MedicalResearch.com: What should readers take away from your report?

Response: BTX is a form of “neuromodulation,” which may represent a novel approach to atrial fibrillation treatment, potentially applicable to the many other clinical contexts in which atrial fibrillation appears.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Large-scale clinical trials have been planned to test the use of BTX in patients undergoing cardiac surgery, in an effort to confirm the pilot program results. If these larger studies are positive, BTX injection may become a routine part of the cardiac surgery procedure.  

MedicalResearch.com: Is there anything else you would like to add?

Response: The Botulinum toxin concept could also be tested in non-postoperative patients in future studies, extending the treatment paradigm of neuromodulation as a stand-alone or supplemental antiarrhythmic strategy.

I am a lead investigator and on the executive committee in the upcoming randomized clinical trial sponsored by Allergan, Inc.

Citation: 

Long-term suppression of atrial fibrillation by botulinum toxin injection into epicardial fat pads in patients undergoing cardiac surgery: Three-year follow-up of a randomized study

Romanov, Alexander et al. Heart Rhythm , Volume 0 , Issue 0 ,

Nov 30, 2018 @ 1:19 am

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