Inflammatory Responses to Surgery and Postoperative Atrial Fibrillation

Karamnov, Sergey; Muehlschlegel, Jochen D.

doi:10.1097/aln.0000000000004233

Cited by 3 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We agree with Karamnov and Muehischlegel 2 that an anti-inflammatory approach using antioxidants reduces NADPH oxidase activity for postoperative atrial fibrillation, a plausible strategy for prophylaxis. 2 However, we have additional potential explanations for why there was no significant difference in the occurrence of postoperative atrial fibrillation in patients who did and did not receive perioperative N -acetylcysteine in the study of Amar et al . 1…”

Section: To the Editorsupporting

confidence: 87%

Section: To the Editormentioning

confidence: 99%

“…We read with interest the recent work of Amar et al ., 1 with the editorial by Karamnov and Muehischlegel 2 which demonstrated the feasibility and safety of an antioxidant, N -acetylcysteine, for the prevention of atrial fibrillation after thoracic surgery. We agree with Karamnov and Muehischlegel 2 that an anti-inflammatory approach using antioxidants reduces NADPH oxidase activity for postoperative atrial fibrillation, a plausible strategy for prophylaxis. 2 However, we have additional potential explanations for why there was no significant difference in the occurrence of postoperative atrial fibrillation in patients who did and did not receive perioperative N -acetylcysteine in the study of Amar et al .…”

Section: To the Editormentioning

confidence: 99%

See 2 more Smart Citations

N-Acetylcysteine and Postoperative Atrial Fibrillation: Comment

Kinoshita

Kawashima²

2022

Anesthesiology

View full text Add to dashboard Cite

show abstract

Section: To the Editorsupporting

confidence: 87%

Section: To the Editormentioning

confidence: 99%

Section: To the Editormentioning

confidence: 99%

See 1 more Smart Citation

N-Acetylcysteine and Postoperative Atrial Fibrillation: Comment

Kinoshita

Kawashima²

2022

Anesthesiology

View full text Add to dashboard Cite

show abstract

Comparison of Amiodarone Loading Dosage in the Treatment of Postoperative Atrial Fibrillation: High Versus Standard Dose Treatment

Sarıçam,

Öcal,

Iscanlı

et al. 2024

CVP

View full text Add to dashboard Cite

Background: Postoperative atrial fibrillation (POAF) is associated with poor outcomes, including hemodynamic instability, stroke, myocardial infarction, and death. In hemodynamic stable patients, the rhythm-control strategy is more advantageous than rate control. Current standard intravenous amiodarone administration has limited success and a delayed effect; the acute success rate is 44% (8-12 h to several days). Purpose: The aim of this study was to evaluate the effectiveness of higher amiodarone loading dosage to restore sinus rhythm in patients with POAF after noncardiac surgery. Methods: This is a prospective, randomized, controlled single-center study. The study included 39 patients with POAF, divided into group I (n=27) (intravenous 600 mg amiodarone loading dosage over 2 h and infusion of 50 mg/h over a 24-h period) and group II (n=12) (standard protocol; 300 mg of bolus intravenously in 30 min and infusion of 50 mg/h over a 24-h period). The primary endpoint of the study was a restoration of sinus rhythm at the 24th hour. Results: Baseline clinical, laboratory and echocardiographic characteristics of both groups were similar. The patients with higher loading amiodarone dosage had earlier restoration of sinus rhythm (2.38 ± 1.41 vs 8.66 ± 2.87 h, respectively; p=0.015). There was no significant difference in achieving sinus rhythm at the 24th hour between both groups. Conclusion: Higher loading amiodarone dosage increased early conversions to sinus rhythm compared with standard amiodarone protocol in patients with POAF.

show abstract

Efficacy of N-acetylcysteine for Prevention of Postoperative Atrial Fibrillation Following Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Hanafy,

Willim,

Suwatri

et al. 2024

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

Background: As the prevalence of coronary artery disease rises, the demand for coronary artery bypass grafting (CABG) increases. A common complication after CABG is postoperative atrial fibrillation (POAF), which is linked to adverse clinical outcomes. N-acetylcysteine (NAC), an antioxidant, may mitigate oxidative stress and reduce the incidence of POAF. This meta-analysis aims to investigate the efficacy of NAC in preventing POAF after CABG. Methods: The meta-analysis was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched multiple databases, including PubMed, Cochrane Library, ProQuest, and ScienceDirect, to identify relevant randomized controlled trials (RCTs). The intervention groups received perioperative NAC therapy, while the control groups received a placebo. The outcomes assessed were POAF incidence, all-cause mortality, and hospital length of stay (LOS). Review Manager 5.3 was used to conduct the meta-analysis. Results: Eleven RCTs involving 648 patients were included. The NAC group comprised 326 patients, while the control group comprised 322 patients. In the pooled analysis, patients in the NAC group had a significantly lower incidence of POAF (odds ratios (OR) = 0.57; 95% confidence intervals (CI) = 0.33 to 0.97; p = 0.04) and a shorter hospital LOS (weighted mean differences (WMD) = –0.66; 95% CI = –1.22 to –0.10; p = 0.02) compared to the control group. However, there was no significant difference in all-cause mortality. Conclusions: The perioperative administration of NAC can effectively reduce the incidence of POAF and hospital LOS in CABG patients. However, larger RCTs are needed to confirm these findings.

show abstract

Inflammatory Responses to Surgery and Postoperative Atrial Fibrillation

Abstract: This editorial accompanies the article on p. 916.

Cited by 3 publications

References 11 publications

N-Acetylcysteine and Postoperative Atrial Fibrillation: Comment

N-Acetylcysteine and Postoperative Atrial Fibrillation: Comment

Comparison of Amiodarone Loading Dosage in the Treatment of Postoperative Atrial Fibrillation: High Versus Standard Dose Treatment

Efficacy of N-acetylcysteine for Prevention of Postoperative Atrial Fibrillation Following Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Contact Info

Product

Resources

About