2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures

Frendl, György; Sodickson, Alissa; Chung, Mina K.; Waldo, Albert L.; Gersh, Bernard J.; Tisdale, James E.; Calkins, Hugh; Aranki, Sary F.; Kaneko, Tsuyoshi; Cassivi, Stephen D.; Smith, Sidney C.; Darbar, Dawood; Wee, Jon O.; Waddell, Thomas K.; Amar, David; Adler, Dale

doi:10.1016/j.jtcvs.2014.06.036

Cited by 268 publications

(305 citation statements)

References 184 publications

(422 reference statements)

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“…According to the literature, postoperative atrial fibrillation (POAF) (or equivalent supraventricular arrhythmia) is a common complication after pulmonary and esophageal surgery, with the incidence between 12% and 44% 1,2 . Some risk factors have been identifi ed, correlation with perioperative mortality and morbidity has been demonstrated, and prophylactic and therapeutic guidelines have been developed 1,2 .…”

Section: Introductionmentioning

confidence: 99%

“…Some risk factors have been identifi ed, correlation with perioperative mortality and morbidity has been demonstrated, and prophylactic and therapeutic guidelines have been developed 1,2 . POAF is associated with hemodynamic instability, heart failure, thromboembolic events, higher resource utilization and, possibly, increased mortality 1 . Th e precise mechanism of POAF development is not well understood 1 .…”

Section: Introductionmentioning

confidence: 99%

“…POAF is associated with hemodynamic instability, heart failure, thromboembolic events, higher resource utilization and, possibly, increased mortality 1 . Th e precise mechanism of POAF development is not well understood 1 . Th e risk factors include history of smoking, obesity, advancing age, atrial dilatation, myocardial ischemia, volume overload, history of heart failure, increased adrenergic and vagal tone, and surgical procedures associated with local or systemic infl ammation 1,2 .…”

Section: Introductionmentioning

confidence: 99%

“…Th e precise mechanism of POAF development is not well understood 1 . Th e risk factors include history of smoking, obesity, advancing age, atrial dilatation, myocardial ischemia, volume overload, history of heart failure, increased adrenergic and vagal tone, and surgical procedures associated with local or systemic infl ammation 1,2 . Th e extent of pulmonary resection is of importance as a risk factor, with the highest rates of incidence noted after pneumonectomies, extrapleural pneumonectomies and lung transplantations 2 .…”

Section: Introductionmentioning

confidence: 99%

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Postoperative Atrial Fibrillation Prophylaxis and Lung Resection – Our Experience with 608 Consecutive Patients

Karadža

Stančić-Rokotov

Macan

et al. 2017

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SUMMARY -Postoperative atrial fi brillation is a common complication after lung resection. It is burdened by increased mortality and morbidity, prolonged hospitalization, and higher resource utilization in thoracic surgery patients. Th erefore, some kind of pharmacological prophylaxis is recommended. In our patients, diltiazem, a calcium antagonist, is administered. We collected data on all 608 patients having undergone lung resection (no less than lobectomy) between November 2012 and May 2015. Th is period included patients having received diltiazem during their postoperative stay in our Intensive Care Unit and surgical ward, and those that did not receive it. Patients having had atrial fi brillation before the surgery and patients with cardiac pacemaker were excluded from the trial. Other patients were divided into three groups: patients with some kind of antiarrhythmic therapy before and continued after the surgery; patients with diltiazem prophylaxis; and patients without any antiarrhythmic prophylaxis. Th e data collected were statistically analyzed. We found no statistically signifi cant diff erence in the incidence of postoperative atrial fi brillation among the groups (p<0.05).

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Postoperative Atrial Fibrillation Prophylaxis and Lung Resection – Our Experience with 608 Consecutive Patients

Karadža

Stančić-Rokotov

Macan

et al. 2017

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“…Kalp cerrahisi sonrası AF gelişme sıklığı %11-40 olarak bildirilmiştir (1,2) . Diğer yandan operasyon sonrası AF gelişmesinin hastanede yatış süresini uzattığı ve 3 kat artmış tromboemboli riski gibi sekonder patolojilere yol açarak ek morbidite ve mortalite riski oluşturduğu saptanmıştır (3) .…”

Section: Introductionunclassified

Evaluation of Risk Factors for Atrial Fibrillation Occurring After Coronary Bypass Surgery

Yanartaş¹

2015

Kosuyolu Heart Journal

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Giriş: Postoperatif atriyal fi brilasyon (AF) kardiyak operasyonlar sonrasında mortalite ve morbiditeye etki eden önemli bir faktördür. Bu çalışmada, kliniğimizde yapılan koroner baypas operasyonları sonrası AF geliş-me sıklığının ve risk faktörlerinin araştırılması amaçlanmıştır. Hastalar ve Yöntem:Kliniğimizde Ocak 2011-Nisan 2011 yılları arasında yapılan koroner baypas operasyonlarının kayıtları retrospektif olarak incelenmiştir. Çalışmaya 211 hasta dahil edilmiştir. Postoperatif AF gelişen hastalar Grup I, gelişmeyen hastalar ise Grup II olarak sınıfl andırılmıştır. İki grup, diabetes mellitus (DM), hipertansiyon (HT), sigara kullanımı, kronik obstrüktif akciğer hastalığı (KOAH), distal anastomoz sayısı ve aort kros klemp süresi (AKK) açısından karşılaştırılmıştır.Bulgular: Grup I'deki hastaların 33 (%68)'ü erkek, 15 (%32)'i kadın hasta, Grup II'deki hastaların 119 (%73)'u erkek, 44 (%27)'ü kadındı. Ortalama yaş Grup I'de 66.2 ± 10.8 yıl, Grup II'de 60.4 ± 9.3 yıl olarak saptandı (p< 0.05). Gruplar arasında DM, sigara alışkanlığı, HT ve KOAH açısından anlamlı fark yoktu. Distal anastomoz sayısı Grup I'de ortalama 5.6 ± 2.1, Grup II'de ise ortalama 3.5 ± 2.4 idi (p< 0.05). AKK süresi I. Grupta ortalama 58.2 ± 29.1 dakika, II. Grupta ortalama 39.6 ± 18.4 dakika olarak bulundu (p< 0.05). Ortalama yatış süresi Grup I'de 5.2 ± 2.6 gün, Grup II'de 4.5 ± 3.1 gün olarak belirlendi. Erken dönem mortalite izlenmedi (Taburculuk sonrası ilk bir ay). Yaş, AKK ve distal anastomoz sayısı, postoperatif AF gelişimini etkileyen temel faktörler olarak belirlendi. Evaluation of Risk Factors for Atrial Fibrillation Occurring After Coronary Bypass SurgeryABSTRACT Introduction: Postoperative atrial fi brillation (AF) is an important determinant of mortality and morbidity after cardiac surgery. In this study, our aim was to examine the incidence of and risk factors for AF developing after coronary bypass surgery. Patients and Methods:Patients undergoing coronary bypass surgery between January 2011 and April 2011 in our department were examined retrospectively. A total of 211 patients were included in the study. Patients with postoperative AF comprised Group I, while those without comprised Group II. The two groups were compared in terms of a number of potential risk factors for AF including the presence of diabetes mellitus (DM), hypertension (HT), cigarette smoking, chronic obstructive pulmonary disease (COPD), number of distal anastomoses, and aortic cross clamp time (ACC).Results: There were 33 (68%) were male and 15 (32%) female patients in Group I and 119 (73%) male and 44 (27%) female patients in Group II, respectively. Mean age was 66.2 ± 10.8 years in Group I and 60.4 ± 9.3 years in Group II (p= 0.001). There were no signifi cant differences between study groups in terms of the incidence of DM, smoking, HT or COPD. Number of distal anastomoses were 5.6 ± 2.1 in Group I and 3.5 ± 2.4 in Group II (p< 0.05). ACC time was 48.2 ± 29.1 and 59.6 ± 18.4 minutes in Groups I and II, respectively (p< 0.05). Mean duration of hospitali...

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Evaluation of the Incidence of New-Onset Atrial Fibrillation After Aortic Valve Replacement

et al. 2019

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IMPORTANCE Data on the burden of new-onset atrial fibrillation after transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (AVR) is limited mostly to small series or post hoc analyses of clinical trials. OBJECTIVES To evaluate the incidence of new-onset atrial fibrillation and assess the incidence of in-hospital mortality associated with new-onset atrial fibrillation after TAVI and AVR. DESIGN, SETTING, AND PARTICIPANTS In this population-based observational study using the National Inpatient Sample and a validation cohort from the New York state inpatient database, the National Inpatient Sample was queried from January 1, 2012, to September 30, 2015, and the New York state inpatient database was queried from January 1, 2012, to December 31, 2014. Hospitalizations of adults undergoing TAVI or isolated AVR were examined. The incidence of in-hospital mortality across groups with new-onset atrial fibrillation was assessed in the National Inpatient Sample cohort using multivariable logistic regression modeling. Statistical analysis was conducted from August 20, 2018, to March 19, 2019. MAIN OUTCOMES AND MEASURES The primary outcome was the occurrence of new-onset atrial fibrillation, which was identified by excluding hospitalizations in which atrial fibrillation was present on admission. The secondary outcome was in-hospital mortality in TAVI and AVR hospitalizations with and without new-onset atrial fibrillation. RESULTS A total of 48 715 TAVI hospitalizations (47.4% women and 52.6% men; mean [SD] age, 81.3 [8.1] years; 82.3% white) and 122 765 AVR hospitalizations (39.0% women and 61.0% men; mean [SD] age, 67.8 [12.0] years; 78.0% white) were identified. New-onset atrial fibrillation occurred in 50.4% of TAVI hospitalizations and 50.1% of AVR hospitalizations. In the multivariable-adjusted model, TAVI and AVR hospitalizations with new-onset atrial fibrillation had higher odds of in-hospital mortality compared with hospitalizations without new-onset atrial fibrillation (TAVI: odds ratio, 1.57; 95% CI, 1.21-2.04; and AVR: odds ratio, 1.36; 95% CI, 1.08-1.70). The results were then confirmed with the New York state inpatient database, which contains a present on arrival indicator. The incidence of new-onset atrial fibrillation was 14.1% (244 of 1736 hospitalizations) after TAVI and 30.6% (1573 of 5141 hospitalizations) after AVR in the New York state inpatient database. CONCLUSIONS AND RELEVANCE In this large nationwide study, a substantial burden of new-onset atrial fibrillation was observed after TAVI and AVR. The incidence of new-onset atrial fibrillation was higher after AVR than after TAVI in a patient-level state inpatient database.

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2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures

Cited by 268 publications

References 184 publications

Postoperative Atrial Fibrillation Prophylaxis and Lung Resection – Our Experience with 608 Consecutive Patients

Postoperative Atrial Fibrillation Prophylaxis and Lung Resection – Our Experience with 608 Consecutive Patients

Evaluation of Risk Factors for Atrial Fibrillation Occurring After Coronary Bypass Surgery

Evaluation of the Incidence of New-Onset Atrial Fibrillation After Aortic Valve Replacement

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