Impact of atrial arrhythmias after esophagectomy on recovery

Abstract

Background:Postoperative atrial arrhythmias (PAAs) are common complications after esophagectomy, however research findings are contradicted on the prognosis. Therefore this meta-analysis was conducted to determine whether PAAs after esophagectomy had an impact on prognosis.Methods:Studies comparing prognosis between patients with and without PAAs after esophagectomy were searched in EMBASE, MEDLINE, and the Cochrane Register. Primary prognosis was perioperative mortality, and secondary prognoses were postoperative complications, length of stay (LOS).Results:Ten studies including 2681 patients were included in this analysis, in which 508 patients (18.9%) experienced PAAs. Patients with PAAs resulted in significantly higher perioperative (odds ratio, OR 4.05[95% confidence interval, CI: 2.45–6.70], P = .40) mortality, longer hospital LOS (mean differences, MD: 1.49 [95% CI: 0.32–2.66]days, P = .01), more incidence of pulmonary pneumonia (OR 2.48 [95% CI: 1.71–3.59], P < .00001), and anastomotic leakage (OR 2.37 [95% CI: 1.39–4.03], P < .00001).Conclusions:Atrial arrhythmias (AAs) after esophagectomy are associated with higher perioperative mortality, longer hospital LOS, and more incidences of complications. Therapeutic strategies against PAAs are pending for further researches.

Impact of Minimally Invasive Esophagectomy in Post-Operative Atrial Fibrillation and Long-Term Mortality in Patients Among Esophageal Cancer

“…3,11,12 In these studies, complications of infections (anastomotic leakage and sepsis) were consistently associated with new-onset atrial fibrillation. 3,12 However, a few studies have been conducted to assess the effects of MIE, which plays a major role in reducing infectious complications 13,14 with no significant impact on anastomotic leakage. [15][16][17] In the present study, we assessed the link between MIE and the incidence of atrial fibrillation after esophagectomy.…”

“…A meta-analysis found that patients with POAF had higher perioperative mortality, longer hospital stays, and a greater incidence of complications. 3 Risk factors, demographic data 4 and medical history 5 were all shown to play a role in the development of POAF.…”

Landiolol hydrochloride for prevention of atrial fibrillation during esophagectomy: a randomized controlled trial

“…In the present study, landiolol did not reduce the frequency of Clavien-Dindo complications in patients undergoing esophagectomy. In this patient population, AF may occur as a prodromal symptom of complications because these two entities are closely related [18][19][20]. An earlier randomized trial showed that landiolol reduced the proportion of Clavien-Dindo complications, although the protocol was switched to an open-label design after AF was diagnosed [11].…”

The role of surgery type in postoperative atrial fibrillation and in-hospital mortality in esophageal cancer patients with preserved left ventricular ejection fraction

“…Postoperative atrial fibrillation (POAF) is one of the most common complications of esophagectomy that often occur within 3 days after esophagectomy [1]. Studies showed that POAF could lead to a longer hospital stay and a greater incidence of other complications [2]. POAF risk is higher among patients who are older [3], racial/ethnic minorities [4], taking perioperative medications such as β-blocker [5], and having hypertension [6] or operative trauma [7].…”