This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in JAMA  Topic Collections  • Drug Therapy, Other  • Nutritional and Metabolic Disorders, Other  • Arrhythmias  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: In response to Dr Oh and colleagues, there was no difference between the hydrocortisone and the placebo groups with respect to the -blocker dose in our study. We have previously shown that intravenous administration of metoprolol is more effective than oral administration in the prevention of AF after cardiac surgery.¹ The most plausible explanation for this is the impaired bioavailability of metoprolol during the first days after cardiac surgery.² We agree that further studies are warranted to investigate the combination of corticosteroids and intravenous metoprolol in the prevention of AF after cardiac surgery.

Dr Augoustides raises questions about other potential confounders. There was no difference between the hydrocortisone and placebo groups concerning magnesium administration perioperatively and postoperatively. Preoperative statin use was not recorded in our study. The first article³ indicating the beneficial effect of atorvastatin in the prevention of atrial fibrillation after cardiac surgery was published in October . . . [Full Text of this Article]

Jari Halonen, MD
jari.halonen@kuh.fi

Juha Hartikainen, MD, PhD
Kuopio University Hospital
Kuopio, Finland

Tapio Hakala, MD, PhD
North Karelia Central Hospital
Joensuu, Finland

RELATED LETTERS

Use of Corticosteroids to Prevent Atrial Fibrillation After Cardiac Surgery
Jaewon Oh, Ji-Hyung Chung, and Seok-Min Kang
JAMA. 2007;298(3):283.
EXTRACT | FULL TEXT  

Use of Corticosteroids to Prevent Atrial Fibrillation After Cardiac Surgery
John G. T. Augoustides
JAMA. 2007;298(3):283.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Corticosteroids for the Prevention of Atrial Fibrillation After Cardiac Surgery: A Randomized Controlled Trial
Jari Halonen, Pirjo Halonen, Otso Järvinen, Panu Taskinen, Tommi Auvinen, Matti Tarkka, Mikko Hippeläinen, Tatu Juvonen, Juha Hartikainen, and Tapio Hakala
JAMA. 2007;297(14):1562-1567.
ABSTRACT | FULL TEXT