The Incidence of Atrial Fibrillation after On-Pump Versus Off-Pump Coronary Artery Bypass Grafting

Arslan, Gökhan; Erol, Gökhan; Kartal, Hakan; Demi̇rdaş, Ertan; Bolcal, Cengiz

doi:10.1532/hsf.3873

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…Low-dose dopamine and norepinephrine have been reported to be associated with the risk of POAF after cardiac surgery. 24,25 AA after PTE was associated with longer LOS and more postoperative complication. 7 Moreover, during the follow-up with a median of 4.2 (1.6-6.3) years, Havranek et al 8 found that AF and atrial tachycardia in CTEPH patients treated with PTE were associated with reduced cardiac functional capacity.…”

Section: Discussionmentioning

confidence: 91%

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Resting heart rate as a preoperative predictor of postoperative atrial fibrillation after pulmonary thromboendarterectomy

Zhen

Lin

et al. 2022

Journal of Cardiac Surgery

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Background As a marker of the autonomic nervous system, resting heart rate is a predictor of postoperative atrial fibrillation (POAF). However, its predictive value for POAF after pulmonary thromboendarterectomy (PTE) has not been adequately studied. Methods We enrolled 97 patients who underwent PTE in our hospital from December 2016 to November 2021 in this retrospective study. Almost all preoperative characteristics, including electrocardiogram, demographics, hematologic and biochemical indices, echocardiography, and pulmonary hemodynamics, were compared between patients with and without POAF. Multivariate logistic regression analysis was used to identify the independent risk factors for POAF after PTE. Results Overall, 21 patients (21.6%) suffered from POAF after PTE. Compared with patients without POAF, those with POAF were older (p = .049), with a higher resting heart rate (p = .012), and higher platelet count (p = .040). In the binary logistic regression analysis, the resting heart rate (odds ratio [OR] = 1.043, 95% confidence interval [CI] = 1.009–1.078, p = .012) and age (OR = 1.051, 95% CI = 1.003–1.102, p = .037) were independent risk factors for POAF after PTE. The optimal cutoff point of resting heart rate was 89.5 with sensitivity and specificity of 47.6% and 77.6%. When the cutoff value of the age was 54.5, its sensitivity for predicting POAF was 71.4%, with a specificity of 59.2%. Conclusions POAF is common after PTE surgery, and the incidence may be underestimated. The resting heart rate and age are independent preoperative risk factors for POAF after PTE. Considering the lower predictive power of the resting heart and age, further large‐scale studies are needed.

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Section: Discussionmentioning

confidence: 91%

“…A majority of CTEPH patients received phenylephrine, rather than low‐dose dopamine and norepinephrine, to maintain systemic blood pressure after PTE surgery. Low‐dose dopamine and norepinephrine have been reported to be associated with the risk of POAF after cardiac surgery 24,25 …”

Section: Discussionmentioning

confidence: 99%

Resting heart rate as a preoperative predictor of postoperative atrial fibrillation after pulmonary thromboendarterectomy

Zhen

Lin

et al. 2022

Journal of Cardiac Surgery

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“…This clearly explains why the POAF patient's mean age is approximately 4.5 years older than that of the non-POAF group. Early mortality has a significant correlation with age as well (12). When age and other risk factors for early mortality are taken into account, it becomes clear that POAF is not an independent cause of early death.…”

Section: Discussionmentioning

confidence: 99%

Consequences of a New Onset Postoperative Atrial Fibrillation on Mortality Following Coronary Artery Bypass Grafting

QURESHI,

ABBAS,

ROOMI

2024

Biol Clin Sci Res J

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Approximately 20% to 40% of individuals having coronary artery bypass grafting (CABG) develop new-onset postoperative atrial fibrillation (POAF). Objective: This study examined the impact of POAF on both early and late mortality following CABG. Methods: This research study was conducted at the Choudhury Pervaiz Elahi Institute of Cardiology in Wazirabad, Pakistan. The study was conducted retrospectively and involved analyzing data from patients who underwent isolated CABG (Coronary Artery Bypass Grafting) surgery between December 2022 and December 2023. The study included 110 participants who had preoperative sinus rhythm and no previous history of atrial fibrillation. To minimize the impact of confounding factors, propensity score matching was used. Both early and late mortality were analyzed using logistic and Cox regression. Results: The study had a mean follow-up time of 18±3.3 months, and 26 patients (23.6%) reported postoperative atrial fibrillation (POAF). The early death rates were 2.2% in all patients, 3.2% in the POAF group, and 1.7% in the non-POAF group (p = 0.001). However, a multivariate analysis did not show POAF as an independent risk factor for early death (p = 0.172). The logistic regression analysis also did not indicate that POAF was a risk factor for early death after quintiles of the propensity score were considered (OR, 1.46; 95% CI, 0.97 to 2.21; p = 0.152). Interestingly, postoperative AF remained an independent risk factor for early death in our multivariate analysis, with an HR of 1.37 (95% CI, 1.05 to 1.84; p = 0.035). Furthermore, the HR of POAF for overall mortality, adjusted for quintiles of the propensity score of POAF, was 1.38 (95% CI, 1.10 to 1.75; p = 0.008). Conclusions: POAF independently predicts overall and late mortality following independent CABG, whereas it does not predict early mortality.

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“…[34] Arslan G's study results suggest that on-pump CABG under CPB is correlated with POAF. [35] Postoperative AF was developed in twenty-five patients (11%). The incidence of POAF was 9.5% and 11.5% in SinaCurcumin™ and placebo groups, respectively.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Post-operative Atrial Fibrillation Following Cardiac Surgery among Asian Population and Preferred Treatment Modalities- A Systematic Review

et al. 2024

IJFMR

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Background: Postoperative atrial fibrillation is a common complication following cardiac surgery. Despite numerous studies, the true prevalence and optimal management strategies remain unclear. This systematic review investigates the prevalence and management techniques followed anmongst Asian population post-cardiac surgery. Methods: A comprehensive search was conducted across multiple databases between 2000 and 2023. Data on study characteristics, prevalence, and treatment modalities were extracted and assessed for quality using standardized tools. Results: Out of 1849 identified studies, 23 met the eligibility criteria, all conducted in Asian countries. The prevalence of POAF ranged from 10 % to 58 % among cardiac surgery patients in individual studies, translating to a calculated mean value of 24.46 % POAF cases in all accumulated eligible studies for prevalence in the Asian population. The prevalence of POAF in the Asian population was calculated to be 20.95%. Treatment modalities such as antiarrhythmics and anticoagulants showed varying efficacy, with dexmedetomidine demonstrating potential preventive effects. Studies highlighted the higher recurrence rates in cardiac surgery compared to non-cardiac surgery patients. Additionally, the association between POAF and adverse outcomes such as stroke and mortality underscores the importance of effective management strategies. Conclusion: Despite limitations in study design and sample sizes, this review provides insights into POAF in Asian cardiac surgery patients. Tailored approaches incorporating antiarrhythmics, anticoagulation, and lifestyle modifications may help mitigate the burden of POAF and improve patient outcomes. Further research is warranted to elucidate optimal management strategies and address existing gaps in knowledge.

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The Incidence of Atrial Fibrillation after On-Pump Versus Off-Pump Coronary Artery Bypass Grafting

Cited by 5 publications

References 28 publications

Resting heart rate as a preoperative predictor of postoperative atrial fibrillation after pulmonary thromboendarterectomy

Resting heart rate as a preoperative predictor of postoperative atrial fibrillation after pulmonary thromboendarterectomy

Consequences of a New Onset Postoperative Atrial Fibrillation on Mortality Following Coronary Artery Bypass Grafting

Prevalence of Post-operative Atrial Fibrillation Following Cardiac Surgery among Asian Population and Preferred Treatment Modalities- A Systematic Review

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