Benefit of ablation of first diagnosed paroxysmal atrial fibrillation during coronary artery bypass grafting: a pilot study

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.

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Letter by Banach et al Regarding Article, "Postoperative Treatment With Carvedilol, a β-Adrenergic Blocker, Prevents Paroxysmal Atrial Fibrillation After Coronary Artery Bypass Grafting"

Circulation Journal ◽

10.1253/circj.72.1388 ◽

2008 ◽

Vol 72 (8) ◽

pp. 1388 ◽

Cited By ~ 2

Author(s):

Maciej Banach ◽

Giovanni Mariscalco ◽

Murat Ugurlucan ◽

Jacek Rysz

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Paroxysmal Atrial Fibrillation ◽

Artery Bypass ◽

Postoperative Treatment ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Adrenergic Blocker

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

Journal of Cardiovascular Pharmacology and Therapeutics ◽

10.1177/1074248420929483 ◽

2020 ◽

Vol 25 (6) ◽

pp. 523-530 ◽

Cited By ~ 1

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.

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