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Postoperative Atrial Fibrillation (postoperative + atrial_fibrillation)

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Medical Sciences100%

Selected Abstracts

Electrocardiographic Activity before Onset of Postoperative Atrial Fibrillation in Cardiac Surgery Patients

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2008
MIRELA OVREIU Ph.D.
Background:Electrocardiographic (ECG) characteristics were analyzed in postoperative cardiac surgery patients in an attempt to predict development of new-onset postoperative atrial fibrillation (AF). Methods:Nineteen ECG characteristics were analyzed using computer-based algorithms. The parameters were retrospectively analyzed from ECG signals recorded in postoperative cardiac surgery patients while they were in the cardiovascular intensive care unit (CVICU) at our institution. ECG data from 99 patients (of whom 43 developed postoperative AF) were analyzed. A bootstrap variable selection procedure was applied to select the most important ECG parameters, and a multivariable logistic regression model was developed to classify patients who did and did not develop AF. Results:Premature atrial activity (PAC) was greater in AF patients (P < 0.01). Certain heart rate variability (HRV) and turbulence parameters also differed in patients who did and did not develop AF. In contrast, P-wave morphology was similar in patients with and without AF. Receiver operating curve (ROC) analysis applied to the model produced a C-statistic of 0.904. The model thus correctly classified AF patients with more than a 90% sensitivity and a 70% specificity. Conclusion:Among the 19 ECG parameters analyzed, PAC activity, frequency-domain HRV, and heart rate turbulence parameters were the best discriminators for postoperative AF. [source]

Risk index for peri-operative atrial fibrillation in patients undergoing open intracranial neurosurgical procedures

ANAESTHESIA, Issue 5 2009
F. Bilotta
Summary The aim of this prospective study was to determine the prevalence of pre-operative atrial fibrillation and the incidence of postoperative atrial fibrillation in patients undergoing elective or emergency intracranial neurosurgical procedures and the relation to survival and neurological outcome at 6-months follow-up compared to patients with sinus rhythm. A total of 2020 patients were enrolled; 1540 patients underwent elective procedures and 480 underwent emergency procedures. Prevalence of pre-operative atrial fibrillation was 3.7% in elective and 7.2% in emergency procedures (p = 0.0012). In patients undergoing elective cerebral procedures with pre-operative atrial fibrillation, compared to patients with sinus rhythm, 6-month neurological outcome and survival rate are similar. In patients undergoing emergency neurosurgical cerebral procedures, the presence of pre-operative atrial fibrillation is related to an increased risk of poor neurological outcome but with similar survival rate. [source]

Gastrointestinal complications after cardiac surgery

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2005
B. Andersson
Background: Gastrointestinal complications after cardiac surgery are often difficult to diagnose, and are associated with high morbidity and mortality rates. The aim of this study was to determine risk factors for these complications. Method: Between 1996 and 2001 data were collected prospectively from 6119 patients who underwent 6186 cardiac surgical procedures. Data from patients who experienced major gastrointestinal complications were analysed retrospectively by univariate and multivariate analysis. Results: Fifty major gastrointestinal complications were identified in 47 patients (incidence 0·8 per cent). Thirteen of these patients died within 30 days. The most common complication was upper gastrointestinal bleeding (16 patients). Intestinal ischaemia was the most lethal complication (eight of ten patients died). Abdominal surgical operations were performed in 12 patients. Multivariate analysis identified nine variables that independently predicted major gastrointestinal complications: age over 80 years, active smoker, need for preoperative inotropic support, New York Heart Association class III,IV, cardiopulmonary bypass time more than 150 min, postoperative atrial fibrillation, postoperative heart failure, reoperation for bleeding and postoperative vascular complications. Conclusion: Nine risk factors for the development of major gastrointestinal complications after cardiac surgery were identified. Gastrointestinal complications were often lethal but did not independently predict death within 30 days. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Statins as Antiarrhythmics: A Systematic Review Part I: Effects on Risk of Atrial Fibrillation

CLINICAL CARDIOLOGY, Issue 10 2009
Hussam Abuissa MD
Background Recent studies have demonstrated that statins may possess antiarrhythmic properties in addition to their lipid-lowering effects. Methods Studies which reported the association of statins with the incidence of atrial arrhythmias were identified through a systematic review of published literature. Results One randomized, placebo-controlled trial of 200 patients undergoing cardiac surgery showed that atorvastatin decreased the incidence of postoperative atrial fibrillation by 61%. Observational studies in patients with stable coronary disease, left ventricular dysfunction, or those undergoing cardiac or noncardiac surgery show that statin therapy is associated with an approximately 50% lower rate of atrial fibrillation. Two small randomized trials reported conflicting results: one showing that atorvastatin reduced the recurrence of AF after electrical cardioversion and the other finding that pravastatin did not. Conclusions Published data suggests that statins may possess antiarrhythmic properties that reduce the propensity for atrial fibrillation. Most of this data is observational; more randomized, placebo-controlled trials are needed. Copyright © 2009 Wiley Periodicals, Inc. [source]