Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia
<p>Abstract</p> <p>Background</p> <p>Atrial fibrillation (AF) occurs in 28-33% of the patients undergoing coronary artery revascularization (CABG). This study focuses on both pre- and peri-operative factors that may affect the occurrence of AF. The aim is to identify th...
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doaj-1f82ab934d7445bdada717776d23d0642020-11-24T21:34:21ZengBMCJournal of Cardiothoracic Surgery1749-80902011-10-016112710.1186/1749-8090-6-127Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemiaAnastasiou NikolaosPanagopoulos NikolaosPanagiotou MatthewDedeilias PanagiotisCrockett James RProkakis ChristosKoletsis Efstratios NDougenis DimitriosApostolakis Efstratios<p>Abstract</p> <p>Background</p> <p>Atrial fibrillation (AF) occurs in 28-33% of the patients undergoing coronary artery revascularization (CABG). This study focuses on both pre- and peri-operative factors that may affect the occurrence of AF. The aim is to identify those patients at higher risk to develop AF after CABG.</p> <p>Patients and methods</p> <p>Two patient cohorts undergoing CABG were retrospectively studied. The first group (group A) consisted of 157 patients presenting AF after elective CABG. The second group (group B) consisted of 191 patients without AF postoperatively.</p> <p>Results</p> <p>Preoperative factors presenting significant correlation with the incidence of post-operative AF included: 1) age > 65 years (p = 0.029), 2) history of AF (p = 0.022), 3) chronic obstructive pulmonary disease (p = 0.008), 4) left ventricular dysfunction with ejection fraction < 40% (p = 0.015) and 5) proximal lesion of the right coronary artery (p = 0.023). The intraoperative factors that appeared to have significant correlation with the occurrence of postoperative AF were: 1) CPB-time > 120 minutes (p = 0.011), 2) myocardial ischemia index < 0.27 ml.m<sup>2</sup>/Kg.min (p = 0.011), 3) total positive fluid-balance during ICU-stay (p < 0.001), 4) FiO<sub>2</sub>/PO<sub>2 </sub>> 0, 4 after extubation and during the ICU-stay (p = 0.021), 5) inotropic support with doses 15-30 μg/Kg/min (p = 0.016), 6) long ICU-stay recovery for any reason (p < 0.001) and perioperative myocardial infarction (p < 0.001).</p> <p>Conclusions</p> <p>Our results suggest that the incidence of post-CABG atrial fibrillation can be predicted by specific preoperative and intraoperative measures. The intraoperative myocardial ischemia can be sufficiently quantified by the myocardial ischemia index. For those patients at risk we would suggest an early postoperative precautionary anti-arrhythmic treatment.</p> http://www.cardiothoracicsurgery.org/content/6/1/127post-CABG atrial fibrillationcardiopulmonary bypasscoronary artery bypass graftingCABGMyocardial Ischemia Indexpostoperative supraventricular arrhythmiaspredictors |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anastasiou Nikolaos Panagopoulos Nikolaos Panagiotou Matthew Dedeilias Panagiotis Crockett James R Prokakis Christos Koletsis Efstratios N Dougenis Dimitrios Apostolakis Efstratios |
spellingShingle |
Anastasiou Nikolaos Panagopoulos Nikolaos Panagiotou Matthew Dedeilias Panagiotis Crockett James R Prokakis Christos Koletsis Efstratios N Dougenis Dimitrios Apostolakis Efstratios Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia Journal of Cardiothoracic Surgery post-CABG atrial fibrillation cardiopulmonary bypass coronary artery bypass grafting CABG Myocardial Ischemia Index postoperative supraventricular arrhythmias predictors |
author_facet |
Anastasiou Nikolaos Panagopoulos Nikolaos Panagiotou Matthew Dedeilias Panagiotis Crockett James R Prokakis Christos Koletsis Efstratios N Dougenis Dimitrios Apostolakis Efstratios |
author_sort |
Anastasiou Nikolaos |
title |
Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia |
title_short |
Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia |
title_full |
Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia |
title_fullStr |
Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia |
title_full_unstemmed |
Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia |
title_sort |
prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia |
publisher |
BMC |
series |
Journal of Cardiothoracic Surgery |
issn |
1749-8090 |
publishDate |
2011-10-01 |
description |
<p>Abstract</p> <p>Background</p> <p>Atrial fibrillation (AF) occurs in 28-33% of the patients undergoing coronary artery revascularization (CABG). This study focuses on both pre- and peri-operative factors that may affect the occurrence of AF. The aim is to identify those patients at higher risk to develop AF after CABG.</p> <p>Patients and methods</p> <p>Two patient cohorts undergoing CABG were retrospectively studied. The first group (group A) consisted of 157 patients presenting AF after elective CABG. The second group (group B) consisted of 191 patients without AF postoperatively.</p> <p>Results</p> <p>Preoperative factors presenting significant correlation with the incidence of post-operative AF included: 1) age > 65 years (p = 0.029), 2) history of AF (p = 0.022), 3) chronic obstructive pulmonary disease (p = 0.008), 4) left ventricular dysfunction with ejection fraction < 40% (p = 0.015) and 5) proximal lesion of the right coronary artery (p = 0.023). The intraoperative factors that appeared to have significant correlation with the occurrence of postoperative AF were: 1) CPB-time > 120 minutes (p = 0.011), 2) myocardial ischemia index < 0.27 ml.m<sup>2</sup>/Kg.min (p = 0.011), 3) total positive fluid-balance during ICU-stay (p < 0.001), 4) FiO<sub>2</sub>/PO<sub>2 </sub>> 0, 4 after extubation and during the ICU-stay (p = 0.021), 5) inotropic support with doses 15-30 μg/Kg/min (p = 0.016), 6) long ICU-stay recovery for any reason (p < 0.001) and perioperative myocardial infarction (p < 0.001).</p> <p>Conclusions</p> <p>Our results suggest that the incidence of post-CABG atrial fibrillation can be predicted by specific preoperative and intraoperative measures. The intraoperative myocardial ischemia can be sufficiently quantified by the myocardial ischemia index. For those patients at risk we would suggest an early postoperative precautionary anti-arrhythmic treatment.</p> |
topic |
post-CABG atrial fibrillation cardiopulmonary bypass coronary artery bypass grafting CABG Myocardial Ischemia Index postoperative supraventricular arrhythmias predictors |
url |
http://www.cardiothoracicsurgery.org/content/6/1/127 |
work_keys_str_mv |
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