Patients with postoperative atrial fibrillation have a doubled cardiovascular mortality

Ahlsson, Anders; Bodin, Lennart; Fengsrud, Espen; Englund, Anders

doi:10.1080/14017430802702291

Cited by 51 publications

(48 citation statements)

References 18 publications

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“…Długoterminowo u pacjentów z epizodem AF w okresie pooperacyjnym stwierdza się 2-krotny wzrost umieralności z przyczyn sercowo-naczyniowych oraz znacznie zwiększone ryzyko AF i udaru niedokrwiennego w przyszłości w porównaniu z pacjentami, u których po operacji utrzymywał się rytm zatokowy [952][953][954][955][956][957][958]. Doustne leczenie przeciwzakrzepowe w momencie wypisania ze szpitala wią-zało się w odległej obserwacji ze zmniejszeniem umieralności u pacjentów z AF w okresie pooperacyjnym [959], choć nie ma dowodów z kontrolowanych prób klinicznych.…”

Section: Leczenie Przeciwzakrzepoweunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

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2,380

4,206

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Section: Leczenie Przeciwzakrzepoweunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

Self Cite

2,380

4,206

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“…4,5 Postoperative AF may lead to serious complications, such as increased risk of acute kidney injury, hemodynamic instability, cardiac failure, stroke, and death. [6][7][8] Postoperative AF substantially increased the cost of coronary artery bypass graft (CABG) as well. [7][8][9][10][11] Guidelines strongly recommend using β-blockers to prevent postoperative AF [12][13][14] ; however, all therapeutic options have variable efficacy and some may adversely affect hemodynamic stability.…”

mentioning

confidence: 99%

“…[6][7][8] Postoperative AF substantially increased the cost of coronary artery bypass graft (CABG) as well. [7][8][9][10][11] Guidelines strongly recommend using β-blockers to prevent postoperative AF [12][13][14] ; however, all therapeutic options have variable efficacy and some may adversely affect hemodynamic stability. [15][16][17][18][19][20] Experimental and clinical data suggest that the autonomic nervous system may play a critical role in the initiation and maintenance of AF.…”

mentioning

confidence: 99%

Long-Term Suppression of Atrial Fibrillation by Botulinum Toxin Injection Into Epicardial Fat Pads in Patients Undergoing Cardiac Surgery

Pokushalov

Kozlov

Romanov

et al. 2015

Circ: Arrhythmia and Electrophysiology

101

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Background-Animal models suggest that the neurotransmitter inhibitor, botulinum toxin, when injected into the epicardial fat pads can suppress atrial fibrillation inducibility. The aim of this prospective randomized double-blind study was to compare the efficacy and safety of botulinum toxin injection into epicardial fat pads for preventing atrial tachyarrhythmias. Methods and Results-Patients with history of paroxysmal atrial fibrillation and indication for coronary artery bypass graft surgery were randomized to botulinum toxin (Xeomin, Merz, Germany; 50 U/1 mL at each fat pad; n=30) or placebo (0.9% normal saline, 1 mL at each fat pad; n=30) injection into epicardial fat pads during surgery. Patients were followed for 1 year to assess maintenance of sinus rhythm using an implantable loop recorder. All patients in both groups had successful epicardial fat pad injections without complications. The incidence of early postoperative atrial fibrillation within 30 days after coronary artery bypass graft was 2 of 30 patients (7%) in the botulinum toxin group and 9 of 30 patients (30%) in the placebo group (P=0.024). Between 30 days and up to the 12-month follow-up examination, 7 of the 30 patients in the placebo group (27%) and none of the 30 patients in the botulinum toxin group (0%) had recurrent atrial fibrillation (P=0.002). There were no complications observed during the 1-year follow-up. Conclusions-Botulinum toxin injection into epicardial fat pads during coronary artery bypass graft provided substantial atrial tachyarrhythmia suppression both early as well as during 1-year follow-up, without any serious adverse events. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01842529.

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“…[1,6,7] An episode of postoperative AF is also associated with decreased longterm survival, which is mainly explained by an increased risk of cardiovascular death. [2,8,9] Both pre-and postoperative AF therefore affect late mortality and morbidity in patients undergoing aortocoronary bypass surgery, and there is a need to study the possible pathophysiological mechanisms in these patients.…”

Section: Introductionmentioning

confidence: 99%

“…Up to 9% of the patients present with preoperative AF accompanying their coronary artery disease, [1] and approximately one-third of CABG patients with preoperative sinus rhythm sustain an episode of postoperative AF. [2,3] Atrial fibrillation per se is associated with a doubled mortality risk and a fivefold increased risk of stroke. [4,5] In cardiac surgery patients, preoperative AF is an independent risk factor for short-and long-term mortality.…”

Section: Introductionmentioning

confidence: 99%

Pre- and postoperative atrial fibrillation in CABG patients have similar prognostic impact

Fengsrud

Englund

Ahlsson

2016

Scandinavian Cardiovascular Journal

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Objectives. To study pre-and postoperative atrial fibrillation and its long-term effects in a cohort of aortocoronary bypass surgery patients. Design. Altogether 615 patients undergoing aortocoronary bypass graft surgery in 1999-2000 were studied. Forty-four (7%) had preoperative atrial fibrillation. Postoperative atrial fibrillation occurred in 165/615 patients (27%) while 406/615 patients (66%) had no atrial fibrillation. After a median follow-up of 15 years, symptoms and medication in survivors were recorded, and cause of death in the deceased was obtained. Results. Death due to cerebral ischaemia was most common in the pre-and postoperative atrial fibrillation groups (7% and 5%, respectively, v. 2% among those without atrial fibrillation, p ¼ .038), as were death due to heart failure (18% and 14%, v. 7%, p ¼ .007) and sudden death (9% and 5%, v. 2%, p ¼ .029). The presence of pre-or postoperative atrial fibrillation was an independent risk factor for late mortality (hazard ratios 1.47 (1.02-2.12) and 1.28 (1.01-1.63), respectively). Conclusions. Patients with pre-or postoperative atrial fibrillation undergoing aortocoronary bypass surgery have increased long-term mortality and risk of cerebral ischemic and cardiovascular death compared with patients in sinus rhythm. ARTICLE HISTORY

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Patients with postoperative atrial fibrillation have a doubled cardiovascular mortality

Abstract: Postoperative AF is an age-independent risk factor for late mortality in CABG patients, explained by an increased risk of cardiovascular death.

Cited by 51 publications

References 18 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Long-Term Suppression of Atrial Fibrillation by Botulinum Toxin Injection Into Epicardial Fat Pads in Patients Undergoing Cardiac Surgery

Pre- and postoperative atrial fibrillation in CABG patients have similar prognostic impact

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