Predictors of postoperative atrial fibrillation

Kadyrova, M. V.; Степанова, Ю. А.; Grinberg, Max; Raguzina, Vlada Yu.; Малышенко, Е. С.; Широков, В. С.; Попов, В. А.; Ревишвили, А. Ш.

doi:10.24835/1607-0763-937

Medicinskaâ vizualizaciâ

2021

DOI: 10.24835/1607-0763-937

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Predictors of postoperative atrial fibrillation

M. V. Kadyrova¹,

Ю. А. Степанова²,

Max Grinberg³

et al.

Abstract: Review purpose: to study the occurrence predictors of postoperative atrial fibrillation (PAF), effective predicting and treating methods according to global literature.Currently, PAF is considered one of the most frequent events among all cardiovascular complications as it develops in 30–65% of cases in patients after heart surgery. In recent decades, the PAF incidence has steadily increased despite advances in surgery and anesthesiology. PAF is a significant complication that affects the course of the postope… Show more

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Cited by 2 publications

References 79 publications

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Association of left ventricular structural remodeling types with fibronectin deficiency in patients with multivessel coronary artery disease

Mingalimova,

Gumanova,

Bikbova

et al. 2023

Russ J Cardiol

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Aim. To evaluate the serum fibronectin level in patients with multivessel coronary artery disease, and to identify the relationship of fibronectin level with atrial fibrillation (AF) developed in the hospital after coronary artery bypass grafting (CABG) and types of left ventricular (LV) structural remodeling.Material and methods. This prospective observational study of 80 patients after elective CABG at the Cardiac Surgery Department № 1 of the N.V. Sklifosovsky Research Institute for Emergency Medicine from October 2020 to May 2022. The groups were divided depending on the development of AF after CABG surgery (19 patients with AF developed in the hospital after CABG (up to 10 days), 61 patients — control group). All patients underwent a general clinical examination and transthoracic echocardiography, with estimation of left ventricular remodeling type. Serum fibronectin level was determined by enzyme immunoassay using the Fibronectin agent (Technozym, Austria).Results. The median fibronectin values in the group with AF was 110,10 [86,86; 134,00] mcg/ml versus 120,90 [92,01; 161,50] µg/ml of the comparison group (p=0,19). The following LV patterns were observed: normal LV geometry (NLVG) — in 1 patient (5,26%), concentric LV remodeling (CLVR) — in 3 patients (15,79%), concentric LV hypertrophy (CLVH) — in 10 patients (52,63%), eccentric LV hypertrophy (ELVH) — in 5 patients (26,32%). In the group without AF, 25 patients (40,98%) were diagnosed with NLVG, 26 patients (42,62%) — CLVR, 6,56% (n=4) — CLVR, while ELVH was diagnosed in 6 patients (9,84%). Differences in geometry types between groups were significant (p<0,0001). Multivariate analysis adjusted for gender, age, cardiopulmonary bypass time, the predictive value remained for CLVH — odds ratio 15,83 (95% confidence interval, 4,082-1,442,00; p=0,0001) and ELVH — odds ratio 5,17 (95% confidence interval, 1,365-19,573; p=0,015). A further study showed that fibronectin <116,496 µg/ml with a sensitivity of 78% and specificity of 53% is associated with CLVH (p=0,006) in patients of both groups.Conclusion. Fibronectin <116,496 µg/ml is associated with CLVH in patients with multivessel coronary artery disease (sensitivity 78%, specificity 53%; p=0,006).

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Association of left ventricular structural remodeling types with fibronectin deficiency in patients with multivessel coronary artery disease

Mingalimova,

Gumanova,

Bikbova

et al. 2023

Russ J Cardiol

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Study of Heart Rate Variability in Patients With Paroxysmal Atrial Fibrillation During Prophylactic Treatment of Metoprolol and Cordarone for One Year

Rybakova

Stolyarova

Gizova

2021

Mediko-farmacevtičeskij žurnal "Pulʹs"

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This work is devoted to the dynamic study of heart rate variability indicators for one year in patients with paroxysmal atrial fibrillation treated with antiarrhythmic drugs metoprolol and cordarone. The study found that patients treated with metoprolol monotherapy had a weakening of parasympathetic effects on the heart, due to a decrease in Mean by 12.9%, Mo by 13%, Amo by 29.4%, SDNN by 28.3% compared to the group of healthy individuals, but they differed in stable indicators of heart rate variability and 33% retained sinus rhythm during the year. With cordarone monotherapy, there was a curative effect of sympathetic and parasympathetic effects on the heart, as indicated by an increase in: Mean by 15.9%, Mo by 15.9%, IVR by 95.5%, Amo by 41.1% and a decrease in SDNN by 37.5%, compared with the group of healthy individuals at the initial stage. A year later, a negative dynamics was revealed - the predominance of sympathetic influences on the heart compared to the groups of healthy individuals and the control due to an increase in: IVR by 363.3% and 238.5%; VPR by 116.7% and 106%; Amo by 111.2% and 72.9; IN by 304% and 246.8%; PAPR by 92% and 79.1%, respectively. During the year, 39% of patients left the study due to the replacement of antiarrhythmic therapy and 16.5% due to the development of a permanent form of atrial fibrillation. In the remaining patients in the study, in comparison with their initial data, there was a predominance of sympathetic effects on the heart due to an increase in IVR by 137%. In combination therapy with metoprolol and cordarone, there were no significant changes in heart rate variability compared to the initial ones. Initially, there was a decrease in overall heart rate variability due to a decrease in SDNN by 28.4% and a decrease in parasympathetic effects on the heart due to an increase in Amo by 45.2% and a decrease in Delta X by 32.9% compared to the group of healthy individuals. After a year, 40% left the study due to the replacement of antiarrhythmic therapy and 30% due to the development of a permanent form of atrial fibrillation. During dynamic observation of patients, it was found that the following indicators have the most important prognostic value in the development of atrial fibrillation: SDNN, Delta X and RMSSD. Therefore, it is very important to register an ECG with the measurement of these indicators at least once every 3 months for timely correction of treatment.

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Predictors of postoperative atrial fibrillation

Cited by 2 publications

References 79 publications

Association of left ventricular structural remodeling types with fibronectin deficiency in patients with multivessel coronary artery disease

Association of left ventricular structural remodeling types with fibronectin deficiency in patients with multivessel coronary artery disease

Study of Heart Rate Variability in Patients With Paroxysmal Atrial Fibrillation During Prophylactic Treatment of Metoprolol and Cordarone for One Year

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