Predictors, prevention, and long-term prognosis of atrial fibrillation after coronary artery bypass graft operations

Rubin, David A.; Nieminski, Karen E.; Reed, George E.; Herman, Michael V.

doi:10.1016/s0022-5223(19)36243-9

Cited by 193 publications

(58 citation statements)

References 11 publications

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“…Development of atrial fibrillation (AF) after cardiac surgery was considered a minor, self-limiting complication until relatively recently. [1][2][3][4][5] Approximately a decade ago, however, evidence started emerging that it was independently associated with poorer survival after coronary artery bypass grafting (CABG). 2,3,[6][7][8][9] It is now recognized as a serious complication, and practice guidelines and quality measures have been introduced related to its prevention.…”

mentioning

confidence: 99%

Underestimation of the incidence of new-onset post–coronary artery bypass grafting atrial fibrillation and its impact on 30-day mortality

Filardo

Pollock

Graca

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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confidence: 99%

Underestimation of the incidence of new-onset post–coronary artery bypass grafting atrial fibrillation and its impact on 30-day mortality

Filardo

Pollock

Graca

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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“…The low figures support the safety of these medications, particularly amiodarone, for the prevention of post‐CABG AF without prominent complications. It should nonetheless be recalled that other studies reported a 15% increase in the incidence of stroke in AF patients, and an increase in the length of hospitalization, rate of heart failure, and frequency of various hemodynamic and neurological problems, and hence in morbidity and mortality [14,21,25].…”

Section: Discussionmentioning

confidence: 99%

“…Although many surgeons hold the view that post‐CABG AF has a benign course, several reports have shown a definite increase in the incidence of stroke, heart failure and poor hemodynamic performance due to impaired left ventricular function, primarily caused by shortened filling time [14–20]. In addition, several reports have indicated increased morbidity, length of hospitalization, and total cost [21–31]. Postoperative AF has also been shown to independently predict postoperative delirium and neurocognitive decline [32,33].…”

Section: Introductionmentioning

confidence: 99%

Ability of Amiodarone and Propranolol Alone or in Combination to Prevent Post‐coronary Bypass Atrial Fibrillation

Kojuri

Mahmoodi

Jannati

et al. 2009

Cardiovascular Therapeutics

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Atrial fibrillation (AF) is the most common arrhythmia in coronary artery bypass grafting (CABG) patients. The purpose of this study was to determine the best prophylaxis for AF prior to CABG. In this double-blind randomized study, 240 consecutive patients underwent elective CABG. They were then divided randomly into three groups to receive propranolol (n = 80), amiodarone (n = 80), or both drugs (n = 80). All groups received their medications from preoperative day 7 to post-CABG day 5. The patients were well matched for age, sex, risk factors, comorbidities, ejection fraction, and cardioplegic technique. Post-CABG AF developed in 22 patients (9.2%) of whom 13 (16.3%) had received propranolol, 5 (6.3%) had received amiodarone, and 4 (5%) had received both drugs. The difference between the propranolol group and the other two groups was statistically significant (P = 0.02), but that between the amiodarone and amiodarone + propranolol group was not significant. Age was a significant predictor of post-CABG AF (P = 0.034). Other factors such as diabetes, sex, hyperlipidemia, smoking, hypertension, family history, cerebrovascular accidents, left atrial size, and ejection fraction were not significant predictors of post-CABG AF. Preoperative amiodarone or amiodarone with propranolol were more effective than propranolol in reducing the frequency of AF. There was a strong relationship between age and the development of AF. (Clinicaltrial.gov registration NCT00654290.)

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“…Atrial fibrillation (AF) is the most common arrhythmic complication of coronary artery bypass graft (CABG), occurring in 10-40% of patients. [1][2][3][4] It has been shown that postoperative AF is associated with an increased risk of stroke, prolonged hospital stay, and worsened cardiac function. [5][6][7][8][9] Incidence of AF remains unacceptably high in high-risk patients receiving optimal medical therapy.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of triple-site triggered atrial pacing for prevention of atrial fibrillation after coronary artery bypass graft surgery

et al. 2005

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SummaryBackground: Recently, several temporary multisite pacing methods have been developed for prevention of postoperative atrial fibrillation (AF).Hypothesis: In this study, we evaluated the effect of triplesite temporary triggered pacing in the AAT mode on the development of AF in patients undergoing coronary artery bypass graft (CABG) at high risk for developing postoperative AF.Methods: A total of 70 patients undergoing CABG were randomly assigned either to pacing group (study group, n = 35 patients) or to no pacing group (control group, n = 35 patients). The external pacemaker was programmed to pace at the atrial triggered mode at a lower rate of 40 beats/min for 4 days.Results: Atrial fibrillation, defined as lasting > 30 s, occurred in 4 patients (11.4%) in the study group and in 16 patients (45.7%) in the control group (p = 0.003). Sustained AF, defined as AF lasting > 10 min, also was observed less frequently in the study group than in the control group (11.6 vs. 37.1%, p = 0.024). Triple-site triggered atrial pacing was observed to reduce the incidence of AF by 75% and the incidence of sustained AF by 69%.Conclusions: We believe that multiple-site temporary pacing in the triggered mode is an effective way of preventing postoperative AF. This technique may be used especially in patients at high risk of developing AF.

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Predictors, prevention, and long-term prognosis of atrial fibrillation after coronary artery bypass graft operations

Cited by 193 publications

References 11 publications

Underestimation of the incidence of new-onset post–coronary artery bypass grafting atrial fibrillation and its impact on 30-day mortality

Underestimation of the incidence of new-onset post–coronary artery bypass grafting atrial fibrillation and its impact on 30-day mortality

Ability of Amiodarone and Propranolol Alone or in Combination to Prevent Post‐coronary Bypass Atrial Fibrillation

Effectiveness of triple-site triggered atrial pacing for prevention of atrial fibrillation after coronary artery bypass graft surgery

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