Study suggests Botox treatment might help prevent AFib after heart surgery

By AMERICAN HEART ASSOCIATION NEWS

ANAHEIM, California — Most widely known for smoothing wrinkles on your face, the neurotoxin Botox treatment could eventually possess a new use: stopping an abnormal heart rhythm that typically develops after heart surgery.

Researchers injected botulinum neurotoxin, offered as Botox treatment, into five fatty areas round the hearts of patients getting surgery at Duke College Clinic in Durham, New York. 60-three patients received Botox treatment and 67 others were injected having a placebo during coronary bypass surgery, heart valve surgical procedures or both.

Publish-surgery AFib happened in 23 patients receiving Botox treatment in contrast to 32 patients obtaining a placebo, a positive change of 11.3 %. However that difference wasn’t considered significant enough to demonstrate the approach labored, cautioned researchers, who presented the findings Wednesday in the American Heart Association’s Scientific Sessions.

Nathan Waldron, M.D., the study’s lead author along with a fellow in cardiothoracic anesthesiology and demanding care medicine at Duke College Clinic, attributed the unclear findings towards the small study size and stated that bigger studies are necessary to further explore the approach.

AFib after heart surgery affects 27 percent to 40 % of patients and can result in longer hospital stays, greater hospital costs and rates of stroke and deaths from the cause. AFib usually occurs 2 to 3 days after surgery, when publish-surgery inflammation peaks, Waldron stated.

“We need new concepts in stopping publish-operative atrial fibrillation,” stated cardiologist Renate B. Schnabel, M.D., of the College of Hamburg in Germany, who wasn’t area of the study. No medications presently used are particularly effective — or safe, she stated.

The search to avoid publish-operative AFib is complicated by many people factors, which makes it hard to study, Waldron stated.

“It’s not merely one mechanism. There is a huge inflammatory response,” he stated.

The main reason investigators made a decision to test Botox treatment happens because it targets our body’s central nervous system, Waldron stated.

“One of the things that that’s become obvious [is the fact that] the autonomic central nervous system plays a sizable role in allowing the background risk and functions like a trigger for publish-operative atrial fibrillation,” he stated. This might happen because the body reacts towards the inflammation caused off by heart surgery.

Experts recognized the research because of its creative approach.

“The authors presented an optimistic, innovative method to reduce publish-operative atrial fibrillation,” Schnabel stated.

And also the approach seems safe. Nevertheless, Schnabel wonders whether the possible lack of negative effects signifies the drug doesn’t have impact on the center whatsoever — bad or good.

Electrophysiologist Kenneth Ellenbogen, M.D., calls it a “very clever solution that’s quite different from what individuals happen to be doing before.”

Because Botox treatment wears off with time, it “doesn’t always hold off within the patient for several days to months to come” like other drugs that make an effort to prevent publish-surgery AFib, stated Ellenbogen, chairman of cardiology at Virginia Commonwealth College in Richmond, who wasn’t area of the study.

Researchers will dive much deeper into study data to consider methods to predict which patients may respond better to Botox treatment treatment after heart surgery, Waldron stated.

For those who have questions or comments relating to this story, please email [email protected].

— Scientific Sessions 2017 news tales