Atrial Fibrillation After Cardiac Surgery

Almassi, G. Hossein; Schowalter, Tracey; Nicolosi, Alfred C.; Aggarwal, Archana; Möritz, Thomas; Henderson, William; Tarazi, Riyad; Shroyer, A. Laurie; Sethi, Gulshan K.; Grover, Frederick L.; Hammermeister, Karl E.

doi:10.1097/00000658-199710000-00011

Cited by 645 publications

(526 citation statements)

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“…1,3,4,6,8,11 Kalavrouziotis et al found that unadjusted mortality rates were similar in patients with and without POAF (3% vs 2.5% respectively, P = 0.99) in a series of 7347 patients undergoing valvular and/or coronary surgery. 6 In contrast, Villareal et al studied patients with isolated CABG and found a strong and independent association between POAF and operative mortality.…”

Section: Impact Of Poaf On Operative Mortalitymentioning

confidence: 98%

“…First, it is well established that POAF increases the risk of perioperative stroke by 2 to 4 fold. 1,3,6 Second, the loss of atrial contraction may substantially reduce cardiac output, which could in turn lead to the development of cardiac and/or renal failure. These perioperative complications may contribute to the increased operative mortality associated with POAF.…”

Section: Impact Of Poaf On Operative Mortalitymentioning

confidence: 99%

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Statins Reduce Short‐ and Long‐Term Mortality Associated With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: Impact of Postoperative Atrial Fibrillation and Statin Therapy on Survival

Girerd¹,

Daleau²,

Voisine

et al. 2012

Clinical Cardiology

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Background:Postoperative atrial fibrillation (POAF) is a frequent complication of coronary artery bypass grafting (CABG) surgery. The objective of this study was to determine the impact of POAF on both short‐ and long‐term mortality following isolated CABG.Hypothesis:POAF is associated with a poorer short and long‐term mortality following CABG.Methods:We retrospectively analyzed the preoperative and operative data of 6728 consecutive patients undergoing a first isolated CABG.Results:The incidence of POAF was 27.8%. Operative mortality was higher in patients with POAF compared to those without POAF (2.3% vs 0.9%, P < 0.001). On multivariate analysis, POAF remained an independent predictor of operative mortality (odds ratio [OR]: 1.78, P = 0.01). Patients with POAF also had reduced long‐term survival (6‐year survival: 85.3% vs 89.2%, P < 0.001). After adjusting for other predictors of mortality, POAF was significantly associated with increased long‐term mortality (hazard ratio [HR]: 1.35, P = 0.04). Of note, after adjustment for potential confounders, statin treatment had a highly protective effect in POAF patients for both operative mortality (OR: 0.38, P = 0.003) and long‐term mortality (HR: 0.62, P = 0.03), whereas it had no significant effect in patients without POAF.Conclusions:POAF is an independent predictor of both short‐ and long‐term mortality following CABG. Moreover, statin therapy was independently associated with better survival in patients with POAF.Dr. Pibarot holds the Canada Research Chair in Valvular Heart Diseases, Canadian Institutes of Health Research. Dr. Mathieu is a research scholar from the Fonds de Recherches en Santé du Québec, Montreal, Canada. Dr. Després has served as a speaker for Abbott Laboratories, AstraZeneca, Solvay Pharma, GlaxoSmithKline, and Pfizer Canada Inc.; has received research funding from Eli Lilly Canada; and has served on the advisory boards of Novartis, Theratechnologies, Torrent Pharmaceuticals Ltd., and Sanofi‐Aventis. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Section: Impact Of Poaf On Operative Mortalitymentioning

confidence: 98%

Section: Impact Of Poaf On Operative Mortalitymentioning

confidence: 99%

Statins Reduce Short‐ and Long‐Term Mortality Associated With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: Impact of Postoperative Atrial Fibrillation and Statin Therapy on Survival

Girerd¹,

Daleau²,

Voisine

et al. 2012

Clinical Cardiology

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“…It has been shown that patients having valvular surgery have a higher incidence of early postoperative AF compared with coronary artery bypass patients. 3,11,12 However, ATA after the Maze procedure have not been examined in detail. The purpose of this study was to define the incidence and natural history of early postoperative ATA after the Maze procedure, and to examine whether the occurrence of these arrhythmias predisposed to late recurrence of AF.…”

mentioning

confidence: 99%

Atrial Tachyarrhythmias After the Maze Procedure

Ishii¹,

Gleva²,

Gamache³

et al. 2004

Circulation

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“…The incidence of postoperative arrhythmia (AF and non-sustained VT) in the current cohort was similar to that in previous reports. 13,17,46 One of the mechanisms explaining the association between depression and arrhythmia is the arrhythmogenic effect of antidepressant medications. Both tricyclic antidepressants and selective serotonin reuptake inhibitors may prolong the QT interval, affect heart rate variability, and cause arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

“…13 Postoperative arrhythmia is one of the most frequent early postoperative complications after CABG surgery and is associated with increased morbidity and mortality. [14][15][16][17] Arrhythmia occurs frequently in patients with depression, irrespective of the presence of coronary artery disease. [18][19][20][21][22][23] One of the plausible mechanisms explaining the relationship between depression and arrhythmia is autonomic dysfunction.…”

Section: Résumémentioning

confidence: 99%