Impairment of baroreflex control of the sinoatrial node after cardiac operations with extracorporeal circulation in man

Marin‐Neto, José Antônio; Carneiro, João José; Maciel, Benedito Carlos; Secches, Antonio L.; Gallo, Lourenço; Terra-Filho, João; Manço, José Carlos; Lima-Filho, Euclydes C.; Vicente, W.; Sader, A A; Amorim, Dalmo S.

doi:10.1016/s0022-5223(19)39089-0

Cited by 8 publications

(1 citation statement)

References 23 publications

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“…Pre-existing electrophysiological vulnerability in the atria, injury from atrial ischemia and reperfusion, impairment of sino-atrial node function due to direct trauma to its nervous suppl [ 5 ] , acute atrial stretch, metabolic derangements and pericarditis are all factors that could contribute to appearance of AF in the early postoperative period [ 1 ] .…”

Section: Introductionmentioning

confidence: 99%

Abnormal heart rate variability and atrial fibrillation after aortic surgery

Compostella¹,

Russo²,

D’Onofrio³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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IntroductionComplete denervation of transplanted heart exerts protective effect against postoperative atrial fibrillation; various degrees of autonomic denervation appear also after transection of ascending aorta during surgery for aortic aneurysm.ObjectiveThis study aimed to evaluate if the level of cardiac denervation obtained by resection of ascending aorta could exert any effect on postoperative atrial fibrillation incidence.MethodsWe retrospectively analysed the clinical records of 67 patients submitted to graft replacement of ascending aorta (group A) and 132 with aortic valve replacement (group B); all episodes of postoperative atrial fibrillation occurred during the 1-month follow-up have been reported. Heart Rate Variability parameters were obtained from a 24-h Holter recording; clinical, echocardiographic and treatment data were also evaluated.ResultsOverall, 45% of patients (group A 43%, group B 46%) presented at least one episode of postoperative atrial fibrillation. Older age (but not gender, abnormal glucose tolerance, ejection fraction, left atrial diameter) was correlated with incidence of postoperative atrial fibrillation. Only among a subgroup of patients with aortic transection and signs of greater autonomic derangement (heart rate variability parameters below the median and mean heart rate over the 75th percentile), possibly indicating more profound autonomic denervation, a lower incidence of postoperative atrial fibrillation was observed (22% vs. 54%).ConclusionTransection of ascending aorta for repair of an aortic aneurysm did not confer any significant protective effect from postoperative atrial fibrillation in comparison to patients with intact ascending aorta. It could be speculated that a limited and heterogeneous cardiac denervation was produced by the intervention, creating an eletrophysiological substrate for the high incidence of postoperative atrial fibrillation observed.

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Section: Introductionmentioning

confidence: 99%