Pharmacologic prophylaxis for atrial fibrillation following cardiac surgery: a systematic review

Koniari, Ioanna; Apostolakis, Efstratios; Rogkakou, Christina; Baikoussis, Nikolaos G; Dougenis, Dimitrios

doi:10.1186/1749-8090-5-121

Cited by 75 publications

(39 citation statements)

References 90 publications

(97 reference statements)

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“…Management of POAF has been extensively studied in cardiac and thoracic patients and the guidelines on the management of these patients have been regularly updated (1,(22)(23)(24)(25)(26). Several large prospective, randomized trials and meta-analyses in cardiac surgery show pharmacologic agents can effectively reduce POAF (1).…”

Section: Discussionmentioning

confidence: 99%

Postoperative Atrial Fibrillation in Liver Transplantation

Xia

Apinyachon

Huang

et al. 2015

American Journal of Transplantation

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Postoperative atrial fibrillation (POAF) is common after major surgeries and is associated with increased morbidity and mortality. POAF after liver transplantation (LT) has not been reported. This study was undertaken to investigate the incidence, impact, and risk factors of POAF in LT patients. After IRB approval, LT between January 2006 and August 2013 at our center were retrospectively reviewed. POAF that occurred within 30 days after LT was included. Patients with and without POAF were compared and independent risk factors were identified by logistic regression. Of 1387 adults LT patients, 102 (7.4%) developed POAF during the study period. POAF was associated with significantly increased mortality, graft failure, acute kidney injury and prolonged hospital stay. Independent risk factors included age, body weight, MELD score, presence of previous history of AF, the vasopressors use prior to LT and pulmonary artery diastolic pressure at the end of LT surgery (odds ratios 2.0-7.2, all p < 0.05). A risk index of POAF was developed and patients with the high-risk index had more than 60% chance of developing POAF. These findings may be used to stratify patients and to guide prophylaxis for POAF in the posttransplant period.

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Section: Discussionmentioning

confidence: 99%

Postoperative Atrial Fibrillation in Liver Transplantation

Xia

Apinyachon

Huang

et al. 2015

American Journal of Transplantation

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“…Postoperative AF may cause hemodynamic deterioration, predispose to stroke and increase mortality. Effective treatment for prophylaxis of postoperative AF is vital as it reduces hospitalization and overall morbidity [18]; however, it is believed that the systemic inflammatory response to surgery may play a role in the development of AF [19].…”

Section: Discussionmentioning

confidence: 99%

Corticosteroides intravenosos no perioperatório reduzem a incidência de fibrilação atrial após cirurgia cardíaca

Abbaszadeh¹,

Khan²,

Mehrani³

et al. 2012

Rev Bras Cir Cardiovasc

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Objective: Corticosteroids decrease side effects after noncardiac elective surgery. A randomized, double blinded, placebo-controlled study was plan to test the hypothesis that standard doses of dexamethasone (6X2) would decrease the incidence of atrial fibrillation (AF) following cardiac surgery.Methods: A total of 185 patients undergoing coronary revascularization surgery were enrolled in this clinical study. The anesthetic management was standardized in all patients. Dexamethasone (6 mg/ml) or saline (1 ml) was administered after the induction of anesthesia and a second dose of the same study drug was given on the morning after surgery. The incidence of AF was determined by analyzing the first 72 hours of continuously recorded electrocardiogram records after cardiac surgery, to determine the incidence and severity of postoperative side effects.Results: 19Abbaszadeh M, et al. -Perioperative intravenous corticosteroids reduce incidence of atrial fibrillation following cardiac surgery: a randomized study Bras Cir Cardiovasc 2012;27(1):18-23 Rev

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“…Notably, recommendations from general cardiac surgery data suggest beta-blockade postoperatively. 27 However, dosing of beta-blockade is limited by the threat of precipitating right-sided heart failure, so more evidence is required before aggressive beta-blocker use is used on patients on LVAD therapy. Increased VA also likely resulted in the increased use of amiodarone seen in our cohort.…”

Section: Ventricular Arrhythmias After Lvad Implantationmentioning

confidence: 99%

Arrhythmias in Patients with Cardiac Implantable Electrical Devices after Implantation of a Left Ventricular Assist Device

Rosenbaum¹,

Kremers

Duval

et al. 2016

ASAIO Journal

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Utilization of continuous-flow left ventricular assist devices (CF-LVADs) for advanced heart failure is increasing, and the role of cardiac implantable electrical devices (CIED) is unclear. Prior studies of the incidence of arrhythmias and shocks are frequently limited by ascertainment. One hundred and seventy-eight patients were examined with a previous CIED who were implanted with a CF-LVAD. Medical history, medications, and CIED data from device interrogations were gathered. A cardiac surgery control group (n = 38) was obtained to control for surgical factors. Several clinically significant events increased after LVAD implantation: treated-zone ventricular arrhythmias (VA; p < 0.01), monitored-zone VA (p < 0.01), antitachycardia pacing (ATP)-terminated episodes (p < 0.01), and shocks (p = 0.01), although administered shocks later decreased (p < 0.01). Presence of a preimplant VA was associated with postoperative VA (odds ratio [OR]: 4.31; confidence interval [CI]: 1.5-12.3, p < 0.01). Relative to cardiac surgery, LVAD patients experienced more perioperative events (i.e., monitored VAs and shocks, p < 0.01 and p = 0.04). Neither implantable cardioverter defibrillator (ICD) shocks before implant nor early or late postimplant arrhythmias or shocks predicted survival (p = 0.07, p = 0.55, and p = 0.55). Our experience demonstrates time-dependent effects on clinically significant arrhythmias after LVAD implantation, including evidence that early LVAD-related arrhythmias may be caused by the unique arrhythmogenic effects of VAD implant.

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Pharmacologic prophylaxis for atrial fibrillation following cardiac surgery: a systematic review

Cited by 75 publications

References 90 publications

Postoperative Atrial Fibrillation in Liver Transplantation

Postoperative Atrial Fibrillation in Liver Transplantation

Corticosteroides intravenosos no perioperatório reduzem a incidência de fibrilação atrial após cirurgia cardíaca

Arrhythmias in Patients with Cardiac Implantable Electrical Devices after Implantation of a Left Ventricular Assist Device

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