l-Carnitine supplementation for the prevention of postoperative atrial fibrillation in aortic valve surgery

Objectives l-Carnitine, a quaternary amine, improves fatty acid metabolism in the heart and has anti-inflammatory effects. Several studies have reported the efficacy of l-carnitine for the prophylaxis of arrhythmia. We assessed the clinical effectiveness of l-carnitine in preventing postoperative atrial fibrillation (POAF) in aortic valve surgery. Methods Thirty patients who underwent aortic valve surgery were included. Fifteen patients had no prophylaxis other than conventional measures (control), while 15 patients received oral l-carnitine for 9 days (daily dose of 3 g). The incidence of POAF during 1 week after surgery was compared between the two groups. The multivariable logistic regression analysis for POAF was performed using the pre- and intraoperative parameters. Results Preoperative characteristics and operative data were comparable between the groups. The POAF rate was significantly lower in the l-carnitine group than in the control (20% and 60%, respectively; P = 0.025). l-Carnitine use was an independently negative predictor for POAF (odds ratio 0.067; 95% confidence interval 0.006-0.768). Conclusions l-Carnitine administration may have potential for the prevention of POAF in aortic valve surgery.