Prophylactic Effects of Metoprolol on the Prevention of Atrial Fibrillation after Cardiac Surgery Are Dose Dependent

2014 ◽  
Vol 17 (1) ◽  
pp. 54 ◽  
Author(s):  
Nan Cheng ◽  
Changqing Gao
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Beta Blockers ◽  
Open Heart Surgery ◽  
Asian Patients ◽  
Different Response ◽  
Prolonged Hospital ◽  
Dose Dependent ◽  
Study Dose

Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. Many studies have reported an incidence of 20%-40% in patients undergoing open heart surgery, and the peak incidence usually occurs between the postoperative days [Fuller 1989; Aranki 1996; Svedjeholm 2000; Maisel 2001]. AF is commonly self-limited and rarely results in postoperative death. However, postoperative AF (POAF) is often associated with complications, including stroke, heart failure, prolonged hospital stay, and increased costs [Maisel 2001; Bramer 2010]. Many pharmacological methods have been used to prevent this complication, and beta-blockers, which have been investigated in several studies, have demonstrated effectiveness [Ali 1997; Connolly 2003; Crystal 2004; Halonen 2006; Imren 2007]. There is currently a consensus in the use of beta-blockers for the prevention of POAF. However, whether the effect of beta-blockers on POAF is dose dependent has not been widely studied [Coleman 2004; Lucio 2004]. In addition, patients with different racial backgrounds have a different response to metoprolol based on body shape. In addition, the CYP2D6 genotypes are different among white and Asian patients. In this study dose-dependent prophylactic effects of beta-blockers, which were obtained in a single center.

Intraoperative CARTO Mapping for Atrial Fibrillation Ablation in Patients Undergoing Cardiac Surgery

2021 ◽  
Author(s):  
Sara Rita Vacirca
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Pulmonary Veins ◽  
Open Heart Surgery ◽  
Atrial Fibrillation Ablation ◽  
Surgical Ablation ◽  
Before And After ◽  
The Mean ◽  
Exit Block

Objective: Intraoperative CARTO Mapping for Atrial Fibrillation ablation in cardiac surgery. Background: Surgical ablation of Atrial Fibrillation is usually performed without mapping. The study aims to determine if intraoperative CARTO can be useful to guide the ablating procedure. Methods and Findings: Fourteen patients with symptomatic and drug-refractory concomitant AF were operated on in 2003 and 2004. CARTO mapping was performed before and after surgical bipolar radio-frequency ablation. Application of energy was repeated when residual electrical activity was detected at the pulmonary veins-atrial junction. Pacing wires were applied on right and left pulmonary veins distally to the ablation line to confirm the exit block. The mapping protocol was completed in 12 patients. Acute left atrium-pulmonary vein isolation was achieved after single or double energy application in 2/12 (16.6%) and 9/12 (75%) patients, respectively. The mean duration of the mapping and ablation procedure was 67 minutes. At discharge, PV isolation persisted in 10 patients: exit block was confirmed by the absence of pacing through the pulmonary veins electrodes. After a mean follows up of 181 months, no further recurrent AF events were registered in 9/12 (69.2%) patients. Conclusions: CARTO system is useful during open-heart surgery to guide the ablating strategy.

scholarly journals Evaluation of the Effect of Lymphocytes, Platelets, Monocytes on the Development of Acute Renal Failure and Atrial Fibrillation After Open Heart Surgery: A Retrospective Study

2021 ◽  
Author(s):  
Fatemeh Javaherforoosh Zadeh ◽  
Mohsen Maleknia ◽  
Marzieh Babazadeh Dezfuly ◽  
Mohammad Reza Javan ◽  
Hashem kazemi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Retrospective Study ◽  
Sensitivity And Specificity ◽  
Heart Surgery ◽  
Hematological Parameters ◽  
Open Heart Surgery ◽  
P Value ◽  
Surgical Trauma ◽  
Open Heart

Abstract BackgroundCardiac surgery is the most well-known treatment for cardiovascular diseases, including coronary artery and valvular heart diseases. Following cardiac surgery, systemic inflammatory responses are induced due to myocardial arrest, surgical trauma and cardiopulmonary bypass (CPB), which lead to greater complications and poorer outcomes in patients. There is growing evidence, that evaluating cellular markers in cardiac surgery patients are promising messengers of inflammation and could predict post-operative inflammatory events. In this study, for the first time, hematological parameters and the ratio of inflammatory cells before, during, and after cardiac surgery are assessed to predict inflammatory complications, such as: acute renal injury (AKI) and atrial fibrillation (AF).Material and MethodsThis retrospective study was performed on patients, who underwent elective open-heart surgery; they referred to Imam Khomeini Hospital in Ahvaz during November 2014 - March 2017. The profiles of 400 cardiac surgery patients, who underwent CABG were scanned to evaluate the relationship between hematological parameters, cellular-inflammatory indexes, and inflammatory events before, during, and after cardiac surgery. In this study, AKI was diagnosed based on KIDGO criteria; Electro Cardiogram (ECG) was also used to diagnose AF. The specificity and sensitivity of biomarkers were assessed through the receiver operating characteristic curve (AUROC).ResultsAccording to the results, the post-operative NLR was significantly associated with AKI (P-Value: 0.03). Serum markers, including BUN and sCr levels were also significantly correlated with AKI and Non-AKI patients in all post-operative periods (P-Value: 0.0001). Hb core related antigen (HbCr) was also associated with AKI as a hematological parameter.ConclusionsThe findings of this study claimed, that post-operative NLR is significantly associated with the occurrence of AKI; it has also the acceptable sensitivity and specificity results. HbCr levels in the postoperative period also has relatively acceptable sensitivity and specificity concerning AKI.

scholarly journals Effect of Alpha-Lipoic Acid on Atrial Fibrillation after Open Heart Surgery

2020 ◽  
Author(s):  
Wael Elfeky ◽  
Dalia R El-Afify
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Lipoic Acid ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Group Versus ◽  
Control Group ◽  
Alpha Lipoic Acid ◽  
Reactive Protein

Background: Postoperative atrial fibrillation (POAF) is associated with increased morbidity and mortality, and an inflammatory process is involved in its pathogenesis. We aimed to study the possible effect of alpha-lipoic acid (ALA) as an antioxidant on atrial fibrillation after cardiac surgery. Methods: The study included ninety patients who underwent cardiac surgery, either valvular or coronary artery bypass grafting using cardiopulmonary bypass, and were randomized into two groups: Control and ALA groups. Blood samples were obtained to measure preoperative and postoperative levels of malondialdehyde (MDA), glutathione, C-reactive protein (CRP) and interleukin-6 (IL-6). The patients were monitored for the occurrence of atrial fibrillation until the day of discharge. Results: POAF occurred in 33% in the control group versus 11% in the ALA group (p=0.011).  When compared to the control group, ALA significantly decreased the postoperative levels of MDA (4.78±0.91 vs. 5.36±1.03 nmol/ml; p= 0.006) CRP (19.44±3.14 vs. 26.56±6.29 mg/dl; p <0.001) and IL-6 (22.25±2.2 vs. 25.37±2.5 pg/ml; p< 0.001) while glutathione level increased significantly in patients who received ALA (26.4±4.59 vs. 23.44±5.11 mg/l; p= 0.005). Conclusion: ALA may help in the prevention of atrial fibrillation following cardiac surgery through exerting antioxidant and anti-inflammatory effects.

scholarly journals Importance of Postoperative Atrial Fibrillation Development in Heart Surgery: Intra-Hospital Outcomes in Santa Catarina Tertiary Cardiology Center

2019 ◽  
Vol 32 (2) ◽  
pp. 76-81
Author(s):  
Ricardo Pereira da Silva ◽  
Larissa Freitas Nunes Goldoni ◽  
Kárila Scarduelli Luciano ◽  
Ana Carolina Gern Junqueira ◽  
Ana Carolina Caldara Barreto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Hospital Stay ◽  
Heart Surgery ◽  
Beta Blockers ◽  
Postoperative Atrial Fibrillation ◽  
Santa Catarina ◽  
Coronary Syndrome ◽  
Duration Of Hospital Stay

Objective: To determine the incidence of postoperative atrial fibrillation (PAF) of cardiac surgery, its impact on morbimortality and duration of hospital stay in a tertiary cardiology center of the state of Santa Catarina, Brazil. Methods: Cohort study with 134 adult patients submitted to cardiac surgery. Results: the incidence was 32.8%. After multivariate analysis, patients who did not receive beta-blockers were associated with PAF with a relative risk odds ratio (RR) 10.73 (p <0.001). The highest rate of cardiovascular events (cerebrovascular accident, mortality, and acute coronary syndrome) was 25% in the PAF group. 10% (RR 3.21; p = 0.035) which, consequently, generated longer hospitalization time in these patients (19.1 vs. 12.5; p = 0.01). Conclusion: the incidence of PAF was high, caused a significant increase in morbimortality and duration of hospital stay, and consolidated the role of beta-blocker therapy in its prevention, and may serve as a basis for future prevention policies.

scholarly journals Factors for the development of atrial fibrillation after open heart surgery

2021 ◽  
Vol 10 (2) ◽  
pp. 40-44
Author(s):  
D. I. Lebedev ◽  
A. V. Evtushenko ◽  
A. A. Khorlampenko
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Left Atrium ◽  
Heart Valves ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Early Postoperative Period ◽  
C Reactive Protein ◽  
Reactive Protein

Aim. To identify the factors influencing the development of postoperative atrial fibrillation (POAF).Methods. The study included 100 patients with indications for cardiac surgery, aged 53 to 82 years (mean age 67.2±17 years). The group included patients who had no history of AF before surgery. Cardiac surgery in the group was presented in 63 patients by coronary artery bypass grafting, and in 37 – by intervention on the heart valves. All respondents were divided into 2 groups: the first included 39 people (39%) who had AF paroxysms lasting more than 30 seconds in the early postoperative period, with a peak at 1–2 days, in 13 (33.3%) cases of AF relapsed. The second group of patients was represented by 61 patients (61%) without cardiac arrhythmias after surgery.Results. The dependence of the development of POAF on age, the concentration of C-reactive protein in the peripheral blood taken on the day of cardiac surgery, the longitudinal size of the left atrium before surgery was revealed.Conclusion. It was found out that a number of factors such as age, preoperative left atrium size, C-reactive protein level in the first days after surgery suggest the development of POAF. The use of the predictors obtained can make it possible to develop an effective strategy for the prevention of POAF. 

Modified Maze Procedure for Patients With Atrial Fibrillation Undergoing Simultaneous Open Heart Surgery

Circulation ◽  
1995 ◽  
Vol 92 (9) ◽  
pp. 359-364 ◽  
Author(s):  
Yoshio Kosakai ◽  
Akira T. Kawaguchi ◽  
Fumitaka Isobe ◽  
Yoshikado Sasako ◽  
Kiyoharu Nakano ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Maze Procedure ◽  
Open Heart
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