Atrial Fibrillation After Coronary Artery Bypass Surgery: Can Ivabradine Reduce Its Occurrence?

Abstract

In patients undergoing elective CABG, adding ivabradine to β-blockers during the perioperative period was associated with reduced incidence of AF at 30-day follow-up, compared with either medication alone.

Atrial Fibrillation in Africa—An Under-Reported and Unrecognized Risk Factor for Stroke: A Systematic Review

“…Four of the studies on heart failure patients were hospital-based and 1 included outpatients [32]. Patients who (recently) underwent cardiac surgery had an AF prevalence of 4.0% to 17.0% [36][37][38][39][40]. Stroke patients, which include patients who had an acute stroke or had a history of stroke, had an AF prevalence of 1.5% to 17.6% [41][42][43][44][45][46][47].…”

“…Prevalence seemed higher in the stroke subpopulation with a range of 31.0% to 93.8%, and it was lowest in RHD patients ranging from 5.2% to 53.3%. Diabetes prevalence ranged from as low as 8% in AF patients without valvular disease in Kenya up to 80.0% in coronary artery bypass surgery patients [27,39]. The definition of vascular disease varied between studies ranging from 6.0% up to 52.2% in postecardiac surgery patients in South Africa [38].…”

Postoperative atrial fibrillation after off-pump coronary artery bypass grafting

“…Iliuta and Rac-Albu documented that prevention of POAF with combination therapy of metoprolol and ivabradine was more effective than with metoprolol or ivabradine alone during the immediate postoperative management of cardiac surgery patients [2]. Abdel-Salam and Nammas also highlighted that in patients undergoing elective coronary artery bypass grafting, adding ivabradine to β-blockers during the perioperative period was associated with reduced incidence of atrial fibrillation at 30-day follow-up, compared with either medication alone [3].…”

“…Moreover, ivabradine is a selective I f current inhibitor that reduces the heart rate without affecting cardiac contractility by selective sinus node inhibition, and has been shown to be cardioprotective in the failing heart [2,3]. Could the author provide relevant information regarding the use of ivabradine in reduction of POAF.…”

Ivabradine Outside the Clinical Guidelines: Interest of a Practitioner

“…В клинических исследованиях ивабрадин также демонстрировал антиаритмические эффекты. Так, в ряде исследований у пациентов, подвергшихся плановому коронарному шунтированию, добавление ивабрадина к ББ во время периоперационного периода было связано с уменьшением частоты послеоперационной ФП при 30-дневном наблюдении по сравнению с монотерапией каждым из препаратов [22,23]. В связи с этим эффектом, пациенты, получавшие ивабрадин, имели более высокое качество жизни, меньшую продолжительность пребывания в стационаре и более короткую продолжительность иммобилизации в послеоперационном периоде.…”