Postoperative atrial fibrillation (AF) is a common complication of coronary artery bypass grafting (CABG). The mean platelet volume (MPV) is an important marker of platelet activity and is associated with cardiovascular risk factors. We investigated whether the MPV is associated with the development of AF after CABG. This study included 208 patients undergoing elective isolated CABG. We evaluated the standard preoperative 12-lead electrocardiograph (ECG) recorded at a paper speed of 25 mm/s obtained for each patient from our hospital records before surgery. All study patients underwent standard CABG requiring cardiopulmonary bypass without concurrent valvular surgery. Forty-three patients were excluded. After CABG, all patients were monitored by telemetry and 12-lead ECGs. AF was defined using the established Society of Thoracic Surgeons definition. Postoperative AF occurred in 38 (22%) patients. The hemoglobin and platelet and leukocyte counts were similar in the groups with and without AF. However, the MPV and neutrophil/lymphocyte ratio were significantly higher in the AF group (8.9 [1.4] vs. 7.9 [1.2], p < 0.001 and 3.2 ± 1.9 vs. 2.6 ± 1.2, p = 0.005, respectively). In addition, the C-reactive protein (CRP) levels were significantly higher in the AF group (8.9 [19.6] vs. 5.3 [8.7], p = 0.025). Multivariate logistic regression analysis showed that MPV and CRP were independent predictors of postoperative AF (odds ratio [OR] 2.564, 95% confidence interval [CI] 1.326-4.958, p = 0.005; OR 1.055, 95% CI 1.000-1.114, p = 0.050, respectively). Our results show that increased platelet activity is associated with the development of AF after CABG.
Congenital Long QT Syndrome (LQTS) is a dangerous arrhythmic disorder that can be diagnosed in children with bradycardia. It is characterised by a prolonged QT interval and torsades de pointes that may cause sudden death. Long QT syndrome is an ion channelopathy with complex molecular and physiological infrastructure. Unlike the acquired type, congenital LQTS has a genetic inheritance and it may be diagnosed by syncope, stress in activity, cardiac dysfunction, sudden death or sometimes incidentally. Permanent pacemaker implantation is required for LQTS with resistant bradycardia even in children to resolve symptoms and avoid sudden death.
Introduction: Congenital atrioventricular block is diagnosed in uterine life, at birth, or early in life. Atrioventricular blocks can be life threatening immediately at birth so urgent pacemaker implantation techniques are requested. Reasons can be cardiac or non-cardiac, but regardless of the reason, operations are challenging. We aimed to present technical procedure and operative results of pacemaker implantation in neonates. Materials and methods: Between June 2014 and February 2021, 10 neonates who had congenital atrioventricular block underwent surgical operation to implant permanent epicardial pacemaker by using minimally invasive technique. Six of the patients were female and four of them were male. Mean age was 4.3 days (0–11), while three of them were operated on the day of birth. Mean weight was 2533 g (1200–3300). Results: Operations were achieved through subxiphoidal minimally skin incision. Epicardial 25 mm length dual leads were implanted on right ventricular surface and generators were fixed on the right (seven patients) or left (three patients) diaphragmatic surface by incising pleura. There were no complication, morbidity, and mortality related to surgery. Conclusion: Few studies have characterised the surgical outcomes following epicardial permanent pacemaker implantation in neonates. The surgical approach is attractive and compelling among professionals so we aimed to present the techniques and results in patients who required permanent pacemaker implantation in the first month of life.
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