Atrial flutter after non-congenital cardiac surgery: Incidence, predictors and outcome

Fatemi, Mostafa; Leledy, Marion; Gal, Grégoire Le; Bezon, Eric; Mondine, P; Blanc, Jean‐Jacques

doi:10.1016/j.ijcard.2010.08.021

Cited by 6 publications

(4 citation statements)

References 39 publications

(38 reference statements)

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“…Clinical risk factors include diabetes mellitus, previous heart failure, COPD, age, male sex, and atrial size abnormalities like cardiomyopathy. 27 Fatemi and colleagues 28 also elucidated a key finding that among CABG and valve procedures, isolated postoperative AFL was more prevalent than isolated POAF. This demonstrated an increase in risk of isolated AFL among POAF patients.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of the benefit of beta-blockers for the reduction of isolated atrial fibrillation incidence after cardiac surgery

et al. 2020

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Objectives: Postoperative atrial fibrillation (POAF) is a common problem of cardiac surgery. Beta-blockers are recognized as effective prophylactic agents available for POAF management. To better understand its effect on isolated atrial fibrillation after cardiac surgery, a meta-analysis was conducted. Methods: Randomized controlled trials (RCTs) were searched and filtered by comparing the efficacy of beta-blockers and control users in isolated POAF for cardiac surgery. Seventeen RCTs were identified and analyzed by typical meta-analysis methods. The search was performed from inception to May 31, 2020. Subgroup analyses were conducted for type of surgery and beta-blocker, starting time and route of administration of beta-blocker, and dosage of intravenous landiolol hydrochloride. Results: Beta-blockers were effective in reducing isolated POAF risk (risk ratio [RR], 0.52 [0.41, 0.66], P ¼ .31, I 2 ¼ 12%). In subgroup analyses, beta-blocker administration during postoperative period (RR, 0.43 [0.29, 0.62], P ¼ .84, I 2 ¼ 0%) and on-pump coronary artery bypass graft (RR, 0.34 [0.04, 3.15], P ¼ .56, I 2 ¼ 0%) had lowest risk of isolated POAF incidence. Intravenous landiolol hydrochloride at 2 mg/ kg/min also had low risk of isolated POAF occurrence. Conclusions: Beta-blocker treatment helps to reduce isolated atrial fibrillation incidence after cardiac surgery. Our subgroup analyses also reveal postoperative betablocker administration after on-pump coronary artery bypass graft surgery is most effective in reducing isolated POAF risk. Intravenous landiolol hydrochloride at a dosage of 2 mg/kg/min has also displayed favorable results. Further trials may be required to explore these factors.

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of the benefit of beta-blockers for the reduction of isolated atrial fibrillation incidence after cardiac surgery

et al. 2020

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“…After examining the abstracts, 39 publications seemed to meet the inclusion criteria. Of these, 14 were excluded for the following reasons: Non-English language [ 32 ], no available data on the outcome of interest in [ 33 – 41 ], heart transplantation [ 42 ], no cardiac surgery [ 43 ], and no atrial fibrillation [ 44 , 45 ]. Finally, the remaining 25 studies [ 6 – 10 , 12 – 31 ] to existing data met our selection criteria and were included in the systematic review.…”

Section: Resultsmentioning

confidence: 99%

Preoperative Antihypertensive Medication in Relation to Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery: A Meta-Analysis

Zhou

Wang

Pan

et al. 2017

BioMed Research International

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Background. We undertake a systematic review and meta-analysis to evaluate the effect of preoperative hypertension and preoperative antihypertensive medication to postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery. Methods. We searched PubMed, Embase, and Cochrane Library (from inception to March 2016) for eligible studies. The outcomes were the effects of preoperative hypertension, preoperative calcium antagonists regimen, preoperative ACE inhibitors regimen, and preoperative beta blocking agents regimen with POAF. We calculated pooled risk ratios (OR) and 95% CIs using random- or fixed-effects models. Results. Twenty-five trials involving 130087 patients were listed. Meta-analysis showed that the number of preoperative hypertension patients in POAF group was significantly higher (P < 0.05), while we found that there are no significant differences between two groups in Asia patients by subgroup analysis, which is in contrast to other outcomes. Compared with the Non-POAF group, the number of patients who used calcium antagonists and ACE inhibitors preoperatively in POAF group was significantly higher (P < 0.05). And we found that there were no significant differences between two groups of preoperative beta blocking agents used (P = 0.08). Conclusions. Preoperative hypertension and preoperative antihypertensive medication in patients undergoing cardiac operations seem to be associated with higher risk of POAF.

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“…Cardiac surgery was associated with a high occurrence of atrial arrhythmias. AF and AFL have been reported in up to 15–40% of patients in the postoperative period following CABG, and a higher occurrence was found in valve surgery (37–50%) ( 37 ). RA incision and atriotomy were very common in valve surgery, and surgical scar contributed to more incidence of atypical AFL when compared with RA appendage cannulation which was performed in CABG.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Recurrent Atrial Tachyarrhythmia After Receiving Atrial Flutter Ablation in Patients With Prior Cardiac Surgery for Valvular Heart Disease

Chou

Chung

Chang

et al. 2021

Front. Cardiovasc. Med.

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Background: Surgical scars cause an intra-atrial conduction delay and anatomical obstacles that facilitate the perpetuation of atrial flutter (AFL). This study aimed to investigate the outcome and predictor of recurrent atrial tachyarrhythmia after catheter ablation in patients with prior cardiac surgery for valvular heart disease (VHD) who presented with AFL.Methods: Seventy-two patients with prior cardiac surgery for VHD who underwent AFL ablation were included. The patients were categorized into a typical AFL group (n = 45) and an atypical AFL group (n = 27). The endpoint was the recurrence of atrial tachyarrhythmia during follow-up. A multivariate analysis was performed to determine the predictor of recurrence.Results: No significant difference was found in the recurrence rate of atrial tachyarrhythmia between the two groups. Patients with concomitant atrial fibrillation (AF) had a higher recurrence of typical AFL compared with those without AF (13 vs. 0%, P = 0.012). In subgroup analysis, typical AFL patients with concomitant AF had a higher incidence of recurrent atrial tachyarrhythmia than those without it (53 vs. 14%, P = 0.006). Regarding patients without AF, the typical AFL group had a lower recurrence rate of atrial tachyarrhythmia than the atypical AFL group (14 vs. 40%, P = 0.043). Multivariate analysis showed that chronic kidney disease (CKD) and left atrial diameter (LAD) were independent predictors of recurrence.Conclusions: In our study cohort, concomitant AF was associated with recurrence of atrial tachyarrhythmia. CKD and LAD independently predicted recurrence after AFL ablation in patients who have undergone cardiac surgery for VHD.

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Atrial flutter after non-congenital cardiac surgery: Incidence, predictors and outcome

Cited by 6 publications

References 39 publications

Meta-analysis of the benefit of beta-blockers for the reduction of isolated atrial fibrillation incidence after cardiac surgery

Meta-analysis of the benefit of beta-blockers for the reduction of isolated atrial fibrillation incidence after cardiac surgery

Preoperative Antihypertensive Medication in Relation to Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery: A Meta-Analysis

Prediction of Recurrent Atrial Tachyarrhythmia After Receiving Atrial Flutter Ablation in Patients With Prior Cardiac Surgery for Valvular Heart Disease

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