Contrasting effects of diabetes and metabolic syndrome on post-operative atrial fibrillation and in-hospital outcome after cardiac surgery

2013 ◽  
Vol 167 (5) ◽  
pp. 2347-2350 ◽  
Author(s):  
Christopher Hurt ◽  
Augustin Coisne ◽  
Thomas Modine ◽  
Jean-Louis Edme ◽  
Xavier Marechal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Metabolic Syndrome ◽  
Cardiac Surgery ◽  
Hospital Outcome ◽  
Post Operative Atrial Fibrillation

Abstract 302: Echocardiographic Parameters in Perioperative Atrial Fibrillation in Cardiac and Non-Cardiac Surgery Patients

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Jaspreet Arora ◽  
Arjun Nair ◽  
Leigh Cagino ◽  
Le Du ◽  
Mikhail Torosoff
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Academic Medical Center ◽  
Study Cohort ◽  
Post Operative Atrial Fibrillation ◽  
Increased Risk ◽  
Social Security Death Index ◽  
New Onset

Background: We hypothesized that patients with new onset atrial fibrillation (AFib) following cardiac or non-cardiac surgery have similar echocardiographic features, regardless of the type of surgery. Methods: Study cohort included 4562 consecutive patients without history of atrial fibrillation undergoing general, thoracic or cardiovascular surgeries at a single tertiary academic medical center. Retrospective chart and echocardiogram review was performed. Chi-square, logistic regression, and analysis of variance were performed. Long-term all cause mortality was determined through Social Security Death Index. The study was approved by the institutional IRB. Results: Post-operative AFib was noted in 24% (275/1141) after cardiac surgery, 1.2 % (10/804) after thoracic non-cardiac surgery, and 0.7% (18/2617) after general non-cardiac non-thoracic surgery (p<0.0001). On available echocardiograms, 18% (48/264) had LV dilatation and 38% (98/261) had moderate or severe LV dysfunction. The left atrium was dilated in 53% (139/260). Moderate or severe tricuspid regurgitation was noted in 11% (15/128), mitral regurgitation in 28% (45/16), mitral stenosis in 13% (11/82), aortic insufficiency in 27% (37/135), and aortic stenosis in 63% (19/135). When adjusted for the presence of coronary artery disease, valvular disease, age, and gender, only aortic valve stenosis remained an important independent predictor of post-operative atrial fibrillation in non-cardiac surgery patients, HR=13.9 (95%CI 1.5-132.3, p<0.022). Conclusion: Despite significantly increased prevalence of new onset AFib after cardiac surgery, pre-existing cardiovascular conditions, specifically aortic valve stenosis, confer an increased risk of post-operative atrial fibrillation rather than the procedure itself. Improved resource utilization can be expected if post-operative ECG monitoring is limited to the high risk patients, identifiable during peri-operative screening. Prospective studies of this important subject are needed.

scholarly journals Does minimal invasive cardiac surgery reduce the incidence of post-operative atrial fibrillation?

2020 ◽  
Vol 23 (1) ◽  
pp. 7
Author(s):  
NikolaosG Baikoussis ◽  
Maria Maimari ◽  
Stelios Gaitanakis ◽  
Anna Dalipi-Triantafillou ◽  
Andreas Katsaros ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Minimal Invasive ◽  
Post Operative Atrial Fibrillation ◽  
Minimal Invasive Cardiac Surgery

Abstract 133: Outcomes Associated With Perioperative Amiodarone in Cardiac Surgery Patients Receiving Metoprolol

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Auras R Atreya ◽  
Aruna Priya ◽  
Mihaela S Stefan ◽  
Quinn R Pack ◽  
Tara Lagu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Treated Group ◽  
Matched Cohort ◽  
Elective Cardiac Surgery ◽  
Randomized Controlled Studies ◽  
Post Operative Atrial Fibrillation ◽  
Risk Patients

Background: Post-operative atrial fibrillation (POAF) after cardiac surgery occurs frequently and the guidelines make a Class I recommendation for peri-operative betablocker use and a Class IIa recommendation for amiodarone use in high risk patients to reduce length of stay and mortality. Our aim was to study the association between perioperative amiodarone use and clinical outcomes in patients already receiving metoprolol, in a real-world cohort. Methods: Using the PREMIER, Inc. data warehouse, we identified patients ≥18 years without atrial fibrillation at baseline, who underwent elective cardiac surgery during years 2013-2014. We included patients with conditions replicating prior randomized controlled studies. We then excluded all patients not receiving metoprolol. Perioperative amiodarone use was defined as administered on the day of surgery or prior to surgery within the same hospitalization. After propensity matching, we compared outcomes for patients receiving perioperative amiodarone + metoprolol vs. those who received only metoprolol. The primary outcome was POAF and secondary outcomes were in-hospital mortality, length of stay and 1 month readmission among survivors. Results: Among 4351 patients who underwent cardiac surgery and received metoprolol at 212 hospitals, 997 (23%) were treated with perioperative amiodarone. We matched 928 (94%) of perioperative amiodarone treated group based on the propensity score. Table 1 shows baseline characteristics and outcomes of interest in the propensity matched cohort. Median age was 66 years and 74% were male. The propensity matched cohort was well balanced on type of surgery and comorbidities and some imbalances remained in demographic variables. After adjusting for unbalanced factors in the matched cohort, perioperative amiodarone+ metoprolol was associated with reduction in POAF (ARR 5.1%; RR 0.81, 95% CI 0.69-0.95). There were no differences in in-hospital mortality, length of stay, 1 month readmission or cost of hospitalization. Conclusions: In this large cohort of propensity matched patients undergoing elective cardiac surgery, perioperative amiodarone use was associated with a modestly significant reduction in POAF rates, but there were no significant relationships with mortality, length of stay, 1 month readmission or costs.

Colchicine in Post-operative Atrial Fibrillation: A Review

2018 ◽  
Vol 24 (6) ◽  
pp. 695-701 ◽  
Author(s):  
Dimitrios A. Vrachatis ◽  
Charalampos Kossyvakis ◽  
Christos Angelidis ◽  
Vasiliki Panagopoulou ◽  
Eleni K. Sarri ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Clinical Practice ◽  
Pulmonary Vein ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Potential Effect ◽  
Review Article ◽  
Current Evidence ◽  
Post Operative Atrial Fibrillation

Post-operative atrial fibrillation (POAF) is a frequent entity increasing hospitalization duration, stroke and mortality. In the recent years, a few studies have sought to investigate the potential effect of colchicine in POAF prevention after cardiac surgery or catheter pulmonary vein isolation for AF. In the present review article, we intend to provide a synopsis of clinical practice guidelines, summarize and critically approach current evidence for or against colchicine as a means of POAF prevention.

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