Cardiac Arrhythmias Following Pneumonectomy

Bailey, C. Cabell; Betts, Reeve H.

doi:10.1056/nejm194308262290902

Cited by 63 publications

(10 citation statements)

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“…For esophageal surgery, prior systematic reviews of the literature pre-1980, from 1980 to 1988, and from 1990 to 2000 had already revealed major improvements in the risk of mortality at 29%, 13%, and 6.7%, respectively. 27 Initially reported by Bailey and Betts in 1943, 28 postoperative AF affects approximately 30% of cases of major noncardiac thoracic surgery. 2,3 In this context, and at a time of focus on enhanced recovery pathways in quality improvement, there is an increased attention on specific complications, their cause, prevention, impact, and management.…”

Section: Discussionmentioning

confidence: 99%

New-onset Atrial Fibrillation Post-surgery for Esophageal and Junctional Cancer

et al. 2014

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A total of 473 patients (mean age: 63 years; 73% male) underwent resection, 51% 2-stage, 18% 3-stage, 12% transhiatal, and 19% extended total gastrectomy. Ninety-six (20%) patients developed new-onset AF, in 18%, 27%, 29%, and 14% of 2-, 3-, transhiatal, and extended total gastrectomy cohorts, respectively (P=0.05). Age, diabetes, neoadjuvant therapy, and cardiac history predisposed (P<0.05) to AF, and AF was significantly (P<0.0001) associated with pneumonia, pleural effusions requiring drainage, and maximum postoperative C-reactive protein (CRP) (P<0.05) but not with anastomotic leak/conduit necrosis or mortality. Amiodarone was the primary treatment in 63% of cases, 1% underwent cardioversion, and 92% were in sinus rhythm on discharge. At a median follow-up of 40 months (7-109 months), the median survival was 40 months versus 53 months in the AF and non-AF cohorts, respectively (P=0.353) CONCLUSIONS: New-onset AF is common, linked to age, diabetes, cardiac disease, and neoadjuvant therapy. It is strongly associated with complications, principally respiratory sepsis, and systemic inflammation. For most, it resolves, with no impact on oncologic outcomes.

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Section: Discussionmentioning

confidence: 99%

New-onset Atrial Fibrillation Post-surgery for Esophageal and Junctional Cancer

et al. 2014

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“…Review of the literature AF is a well-known postoperative complication, especially in patients who have had cardiothoracic operations (32). In particular AF is very cornmon after CABG surgery.…”

Section: Chaptermentioning

confidence: 99%

Nodal vessels disease as a risk factor for atrial fibrillation after coronary artery bypass graft surgery

Al-Shanafey¹,

Dodds

Langille

et al. 2001

European Journal of Cardio-Thoracic Surgery

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“…Since 1943, when the first supraventricular arrhythmia following pulmonary resection was reported, postoperative atrial fibrillation (POAF) has been a common and well-recognized complication to non-cardiac thoracic surgery [1] [2] [3]. The incidence is ranging from 3% -60%, with a tendency towards an even higher rate, in patients undergoing more invasive surgical procedures, such as lobectomy and pneumonectomy [2] [3] [4] [5].…”

Section: Introductionmentioning

confidence: 99%

Amiodarone for Postoperative Atrial Fibrillation in Lung Cancer Patients: A 6-Year Follow-Up Study

Enevoldsen¹,

Borregaard

Riber

et al. 2020

OJTS

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Background: The preventive effect of prophylactic amiodarone on postoperative atrial fibrillation (POAF) in patients undergoing thoracic surgery has previously been demonstrated. Meanwhile, the long-term effect remains unknown. We investigated the long-term effect of prophylactic amiodarone, in patients undergoing surgery for lung cancer, along with the long-term prognosis of patients with POAF within 6 years of follow-up. Methods: Using data from national databases, we retrospectively analysed 250 patients included and randomized, in the randomized control trial, PASCART, in which patients were allocated to receive either amiodarone or placebo as prophylaxis for POAF. Prophylactic groups, and subgroups, were compared on a number of outcomes. Long-term overall survival was evaluated using Kaplan-Meier survival curves, and Cox proportional hazards models were used for multivariable analysis. Competing risk analysis was used to evaluate time-to-event data in presence of competing risk. Results: When comparing the prophylactic groups, prophylaxis with amiodarone was not convincingly related to a higher frequency of long-term side effects. Patients who developed POAF, were more likely to develop late atrial fibrillation (AF) and POAF was associated with an increased risk of late AF in both the competing risk analysis hazard rate (HR) 4.80 [95% 1.75; 13.18] and multivariable analysis of the Cox regression, HR 5.03 [95% 1.80; 14.10]. When comparing the Kaplan Meier survival curves between groups, we found no statistically significant difference in the long-term overall survival. Conclusions: Intravenous prophylactic amiodarone is safe in patients undergoing lung cancer surgery. POAF is associated with an increased risk of late AF.

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Cardiac Arrhythmias Following Pneumonectomy

Cited by 63 publications

References 0 publications

New-onset Atrial Fibrillation Post-surgery for Esophageal and Junctional Cancer

New-onset Atrial Fibrillation Post-surgery for Esophageal and Junctional Cancer

Nodal vessels disease as a risk factor for atrial fibrillation after coronary artery bypass graft surgery

Amiodarone for Postoperative Atrial Fibrillation in Lung Cancer Patients: A 6-Year Follow-Up Study

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