Botox After Bypass Surgery Evens Out Heart Rhythms, Study Says

It’s a staple in any dermatologist’s office for releasing wrinkles, but botox could one day become a routine part of heart bypass surgeries, the latest research suggests.

Researchers report in the journal Circulation: Arrhythmia and Electrophysiology that shots of botox into the heart can keep its beating more regular and lower the risk of serious post-surgery complications like stroke, heart attack and kidney failure. Anywhere from 10% to 50% of patients who receive heart bypass surgery to circumvent blocked vessels in the heart can develop abnormal heart rhythms. Such arrhythmia can increase time in the intensive care unit and hamper recovery, even lowering five-year survival after the procedure.

Researchers led by Dr. Jonathan Steinberg, director of the arrhythmia institute at Valley Health System and adjunct professor at the University of Rochester, investigated what effect botox injections might have on stabilizing heart rhythms after surgery. In animals, botox, which comes from botulinum toxin, acted on the nerves feeding into the heart and changed the electrical signaling that regulated the beating patterns of the heart. But there were no studies looking at what effect botox might have on human patients.

Steinberg and his colleagues collaborated with doctors in Russia to test the injections in a group of 60 patients who had irregular heart rhythms and were scheduled to have heart bypass operations. Half randomly received the botox shots into the fat surrounding the heart, while half received saline injections. Only 7% of the patients receiving botox developed arrhythmias in the 30 days following their surgery, compared to 30% of the placebo group. A year after their operations, none in the botox group showed abnormal heart rhythms, while 27% who got saline did.

The findings are especially encouraging, since current ways of treating arrhythmia using beta blockers and other medications after bypass aren’t particularly effective.

Botox may work by paralyzing, in a way, some of the excitatory signals sent to the heart following the trauma of surgery. By suppressing some of this activity, the heart rhythm may have a chance to stabilize more quickly, says Steinberg.

He’s also optimistic that the results may help other cases of irregular heart beating as well. “We believe this findings may be relevant to other forms of atrial fibrillation,” he said in a written response to questions. “Our patients all had atrial fibrillation prior to surgery and demonstrated long-lived atrial fibrillation reduction…extending out to one year.”

The study, however, involved a small number of patients, so the injections will have to be tested in a larger group of those undergoing open heart surgery. But the results are encouraging for addressing one of the major complications of bypass surgery and could reduce complications from the operation.