scholarly journals Feasibility of landiolol and bisoprolol for prevention of atrial fibrillation after coronary artery bypass grafting: A pilot study

2012 ◽  
Vol 144 (5) ◽  
pp. 1241-1248 ◽  
Author(s):  
Akira Sezai ◽  
Tishiko Nakai ◽  
Mitsumasa Hata ◽  
Isamu Yoshitake ◽  
Motomi Shiono ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Pilot Study ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Surgical Feasibility of the Injection of Fibrin Sealant in Cardiac Fat Pads to Reduce the Incidence of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting or Valve Surgery: A Pilot Study

2008 ◽  
Vol 3 (3) ◽  
pp. 151-154
Author(s):  
Konstantinos Chryssagis ◽  
Stefan Klügl ◽  
Aris Liangos ◽  
Klaus J. Gutleben ◽  
Johannes Brachmann ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Pilot Study ◽  
Coronary Artery Bypass ◽  
Fibrin Sealant ◽  
Artery Bypass ◽  
Valve Surgery ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Objective Atrial fibrillation (AF) is the most common complication following coronary artery bypass grafting or valve surgery. The autonomic nervous system is an important determinant in the development of AF. We have assessed the role of injection of fibrin sealant (FS) as a method to modify conduction in the fad pads, to mimic temporary denervation and to reduce the incidence of postoperative AF in patients undergoing coronary artery bypass grafting or valve surgery. Patients and Methods Twenty eligible patients who underwent coronary bypass grafting or aortic valve surgery in our Institution were included in this pilot – study. Detection of AF after surgical intervention was based on patient symptomatology and on daily electrocardiograms obtained on all patients. Telemetry was used in all patients for the entire hospitalization period. Results 20% of the studied population (n = 4) developed postoperative AF. At the time of discharge one patient (5%) had persistent AF. Postoperative mortality was 5% (n = 1) and not cardiac related. None of the patients required permanent pacemaker implantation. Conclusions This first human study of FS injected into the anterior fad pads following low to moderate risk open heart surgery shows, that this procedure is safe and feasible. Moreover, CM −1 injection appears to reduce the need for postoperative intervention and/or treatment of AF by diminishing its incidence.

Comparison of Anticoagulants for Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: A Pilot Study

2020 ◽  
Vol 25 (6) ◽  
pp. 523-530 ◽  
Author(s):  
Todd W. Chapin ◽  
David D. Leedahl ◽  
Andrew B. Brown ◽  
Andrew M. Pasek ◽  
Mitchell G. Sand ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Pilot Study ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Oral Anticoagulants ◽  
Postoperative Atrial Fibrillation ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Background: Direct-acting oral anticoagulants are indicated for the treatment of nonvalvular atrial fibrillation, but their use in patients after undergoing cardiac surgery is poorly defined despite a high prevalence of postoperative atrial fibrillation in this population. Methods: Patients diagnosed with postoperative atrial fibrillation were prospectively randomized to warfarin or apixaban. Safety, efficacy, and economic outcomes were evaluated until their 4- to 6-week postoperative appointment. Results: While this pilot study was not powered to determine a difference in safety or efficacy, adverse event rates were similar to the published literature. It was noted that a patient’s course of therapy when utilizing apixaban was significantly less costly than warfarin when including medication, bridging, and laboratory expenses. Conclusion: Apixaban and warfarin both appeared to be safe and effective for anticoagulation throughout the duration of this pilot study in treating postoperative atrial fibrillation after coronary artery bypass grafting. Apixaban was associated with significantly less expense when bridging and monitoring costs were included in addition to medication expense.

Predictors of postoperative atrial fibrillation persisting beyond hospital discharge after coronary artery bypass grafting

Perfusion ◽  
2020 ◽  
pp. 026765912097864
Author(s):  
Aschraf El-Essawi ◽  
Ahmed Abdelhalim ◽  
Steffen Groeger ◽  
Ingo Breitenbach ◽  
Rene Brouwer ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Hospital Stay ◽  
Coronary Artery Bypass ◽  
Hospital Discharge ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Holter Monitor

Objective: Minimal invasive extracorporeal circuits (MiECC) have been associated with a significant reduction in the incidence of postoperative atrial fibrillation (AF). Nevertheless, AF remains one of the most common complications following elective primary coronary artery bypass grafting (CABG). The aim of this study was to identify the predictors of AF persisting beyond the hospital stay in elective primary CABG patients. Methods: We conducted a retrospective analysis for the predictors of AF that persisted beyond discharge between all patients who received an elective isolated CABG in our institution between 2009 and 2014. Patients with a positive history for intermittent or persistent AF were excluded from the analysis. Almost all patients were discharged to a rehabilitation facility where they stayed for 3 to 4 weeks postoperatively. At rehab approximately 91% of them received Holter monitoring at least once prior to their discharge. Results: A total of 770 patients were included in the analysis of which 763 patients survived the in-hospital stay. The incidence of AF at hospital discharge was 4.2% (32/763) while that on Holter monitor at Rehab was 1.5% (10/685). Age and the type of extracorporeal circuit (ECC) utilized were the only significant predictors for both AF at discharge ( p < 0.01 both) and on Holter monitor in rehab ( p < 0.01 and 0.02, respectively). This was also confirmed on multivariate analysis. Conclusion: Our findings show that the benefits of MiECC regarding the incidence of postoperative AF persist beyond hospital discharge. They may thus positively influence the outcomes of patients beyond the early postoperative period.

Frailty syndrome as an independent predictor of unfavorable outcome in patients undergoing coronary artery bypass grafting

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Krivoshapova ◽  
O.L Barbarash ◽  
E.A Wegner ◽  
N.A Terentyeva ◽  
I.I Grigorieva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Postoperative Period ◽  
Artery Bypass ◽  
Early Postoperative Period ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Risk Of Death

Abstract Purpose To assess the prevalence of frailty in the preoperative period and to evaluate its effect on the risk of complications and adverse outcomes in patients undergoing coronary artery bypass grafting (CABG). Methods 303 patients undergoing preoperative management for elective primary CABG were recruited in the study. The study cohort was divided into three groups depending on the PRISMA-7 scores suggesting the presence or absence of frailty and the presence of prefrailty. Statistical analysis was performed using the commercially available software package STATISTICA 8.0.360.0 for Windows (StatSoft, Inc., USA) and SPSS Statistics v. 17.0.0. Results 46 (15%) patients had frailty, while 49 (16%) patients were diagnosed with prefrailty. 208 (69%) patients did not have any signs of frailty. All three groups had significant age differences, therefore only elderly patients aged of 67.0±6.5 years with frailty were allocated for subsequent analysis (prefrailty group - 62.3±7.4 years old, patients without frailty - 60.0±7.7 years, p=0.003). Patients with frailty or prefrailty more often suffered from diabetes mellitus (patients without frailty - 19.2%, prefrailty group - 30.6% and frailty group - 28.3%, p=0.05), arterial hypertension (69.2%, 93.9% and 95.7%, respectively, p&lt;0.001), atrial fibrillation or flutter (7.2%, 14.3% and 19.6%, respectively, p=0.03), chronic heart failure class 3–4 (7.2%, 10.2% and 8.7%, respectively, p=0.002), and peripheral arterial disease (22.6%, 38.8% and 58.7%, respectively, p&lt;0.001). Three groups were comparable in main clinical and demographic parameters. There were no significant differences found in the incidence of postoperative atrial fibrillation or flutter (15.9%, 8.2% and 6.5%, respectively, p=0.07) and infections (1.9%, 0% and 4.3%, respectively, p=0.640). The incidence of myocardial infarction in the intra- and early postoperative period after CABG did not differ significantly between the groups (0.5%, 2% and 0%, respectively, p=0.328) as well as the incidence of stroke (2.4%, 2% and 0%, respectively, p=0.640). Patients with frailty and prefrailty had significantly higher cerebrovascular and cardiovascular mortality compared to those without frailty (8.2%, 2.2% and 0.5%, respectively, p=0.001). Conclusion Almost 15% of patients referred to CABG suffered from frailty. The presence of prefrailty or frailty increases the risk of death in the early postoperative period after CABG. Funding Acknowledgement Type of funding source: None

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