The role of ascorbic acid in the prevention of atrial fibrillation after elective on-pump myocardial revascularization surgery: a single-center experience - a pilot study

Abstract

Atrial fibrillation (AF) is a common arrhythmia that occurs postoperatively in cardiac surgery. There is evidence for the role of oxidative stress in the etiology of AF. In our study, we examined whether antioxidant ascorbic acid (vitamin C), could help in the reduction of the incidence of postoperative AF. Patients who were scheduled to undergo elective isolated on-pump coronary artery bypass grafting (CABG) were included in our study. One hundred and seventy patients were randomly divided in two groups: Group A (n=85) received vitamin C preoperatively and postoperatively whereas Group B (n=85) did not receive any (control group). The incidence of AF was 44.7% in the vitamin C group and 61.2% in the control group (P=0.041). The hospitalization time, the intensive care unit stay and the time interval for the conversion of AF into sinus rhythm was significantly shorter in the vitamin C group. Patients that developed AF also had longer hospital length of stay (9.5±2.8 days vs. 6.7±1.9, P=0.034). Supplementation of vitamin C reduces the incidence of postCABG AF, and decreases the time needed for rhythm restoration and length of hospital stay.

Antioxidant Therapies in the Prevention and Treatment of Atrial Fibrillation

“…The authors concluded that ascorbic acid can be prescribed as an adjunctive therapy to β-blockers for the prophylaxis of POAF. Finally, Papoulidis et al [19] evaluated the preventive effects of Vitamin C on POAF incidence in 170 patients undergoing isolated onpump CABG. Importantly, all the patients were under β-blockers therapy preoperatively.…”

Antioxidant Supplementation Attenuates Oxidative Stress in Patients Undergoing Coronary Artery Bypass Graft Surgery

“…Ascorbic acid was shown to reduce post-operative AF, decrease time in the ICU and hospital, and reduce the time interval needed for rhythm restoration (Papoulidis et al 2011). Female patients suffering from coronary artery dis-ease have also been reported to have significantly decreased α-tocopherol levels (Cavalca et al 2009).…”

Effect of oral vitamin C on atrial fibrillation development after isolated coronary artery bypass grafting surgery: A prospective randomized clinical trial

“…Another study has investigated the role of oral ascorbic acid in the attenuation of postoperative AF in patients who underwent CABG, and interestingly led to decrease in AF occurrence from 34.9% for control to 16.4% for vitamin C group [2]. The study of Papoulidis et al [20] has indicated that taking vitamin C reduced the rate of AF in comparison with not taking any (44.7% vs. 61.2%). They also found significant decreases in the time of AF conversion to SR (7.3 ± 2.1 h in control vs. 5 ± 1.3 h in vitamin C group), and the length of hospital stay (9.5 ± 2.8 days in control vs. 6.7 ± 1.9 days in treatment group).…”