Vitamin C May Prevent Atrial Fibrillation after Heart Surgery

Atrial fibrillation (AF) is a common cardiac rhythm disturbance that can lead to complications like stroke and heart failure. AF may also be caused by stressful events and about 30% of sufferers who undergo cardiac operations suffer from post-operative atrial fibrillation (AF).

Harri Hemilä from the University of Helsinki, Finland, and Timo Suonsyrjä from the Helsinki University Central Hospital, Finland performed a systematic review of vitamin C for preventing AF in high risk sufferers. They identified 14 randomized trials totaling 2006 patients who had gone through cardiac surgery, and one trial with 44 patients that had investigated the recurrence of AF after a successful cardioversion.

There was massive heterogeneity between the 14 cardiac surgery trials, but the heterogeneity was explained using the division of them between 5 trials applied in the US and 9 trials performed outside of the US. The five cardiac surgical procedure trials carried out in the USA uniformly observed no outcome of vitamin C towards post -operative AF. In contrast, the 9 cardiac surgery trials performed outside of the US showed a mean reduction of 44% within the incidence of post-operative AF and there was no heterogeneity between these 9 trials. Five of the latter trials have been done in Iran, two in Greece, one in Slovenia and one in Russia.

The only study on the recurrence of AF after a successful cardioversion, which was done in Greece, discovered that vitamin C decreased the risk of AF recurrence by 87%.

In the non-US cardiac surgery trials, vitamin C reduced the length of clinic stay by 12.6% and intensive care unit stay by 8.0%.

Some of the surgery patients within the non-US studies have been administered vitamin C orally, whereas in others vitamin C was administered intravenously. The latter route results in notably better levels of vitamin C in the blood, consequently the effects of the two  administration approaches could vary.

Oral administration of vitamin C decreased the incidence of post-operative AF by 73%, whereas intravenous administration diminished it by 36%. Then again, oral administration shortened the length of hospital stay by 7% (0.4 days), whereas intravenous administration decreased it by 16% (1.5 days). Thus, the influence of intravenous diet C administration was increased with hospital length stay, however less for the occurrence of post-operative AF.

According to the authors, vitamin C is a safe inexpensive predominant nutrient. Given the constant proof from the less wealthy countries, vitamin C can be administered to cardiac surgery patients, although further research is needed to find out high-quality protocols for its administration. However, there seems to be no purpose for further studies of unselected patients in wealthy international locations; however the effects of vitamin C for sufferers who have a peculiarly low documented level of vitamin C might nonetheless be worthwhile.