Epicardial botulinum toxin injection was associated with "a numerically lower risk of postoperative atrial fibrillation (AFib)," in coronary artery bypass grafting (CABG) patients, according to results from the TNT-POAF trial presented November 15, at American Heart Association (AHA) Scientific Sessions 2017.

Nathan H. Waldron, MD, MHS, et al., looked at 130 patients undergoing CABG, valve surgery, or CABG plus valve surgery who were randomized to receive an injection of botulinum toxin (250 units) or normal saline (5mL) in 5 epicardial fat pads.

Results showed that epicardial botulinum toxin injection was associated with "a numerically lower risk of postoperative AFib," however this difference "did not reach statistical significance."

Further, epicardial botulinum treatment was not associated with an increase in adverse events, duration of postoperative mechanical ventilation, or length of stay vs normal saline.

"These data indicate that epicardial botulinum may be a viable strategy to prevent postoperative AFib prevention and should be studied in a larger-scale trial," researchers concluded.