Abnormal heart rate variability and atrial fibrillation after aortic surgery
Introduction: Complete denervation of transplanted heart exerts protective effect against postoperative atrial fibrillation; various degrees of autonomic denervation appear also after transection of ascending aorta during surgery for aortic aneurysm. Objective: This study aimed to evaluate if the le...
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Sociedade Brasileira de Cirurgia Cardiovascular
2015-02-01
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doaj-f5d4016f336646a8897e22e0be2f8e872020-11-25T01:01:49ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412015-02-01301556210.5935/1678-9741.20140100S0102-76382015000100012Abnormal heart rate variability and atrial fibrillation after aortic surgeryLeonida CompostellaNicola RussoAugusto D’OnofrioTiziana SetzuCaterina CompostellaTomaso BottioGino GerosaFabio BellottoIntroduction: Complete denervation of transplanted heart exerts protective effect against postoperative atrial fibrillation; various degrees of autonomic denervation appear also after transection of ascending aorta during surgery for aortic aneurysm. Objective: This study aimed to evaluate if the level of cardiac denervation obtained by resection of ascending aorta could exert any effect on postoperative atrial fibrillation incidence. Methods: We retrospectively analysed the clinical records of 67 patients submitted to graft replacement of ascending aorta (group A) and 132 with aortic valve replacement (group B); all episodes of postoperative atrial fibrillation occurred during the 1-month follow-up have been reported. Heart Rate Variability parameters were obtained from a 24-h Holter recording; clinical, echocardiographic and treatment data were also evaluated. Results: Overall, 45% of patients (group A 43%, group B 46%) presented at least one episode of postoperative atrial fibrillation. Older age (but not gender, abnormal glucose tolerance, ejection fraction, left atrial diameter) was correlated with incidence of postoperative atrial fibrillation. Only among a subgroup of patients with aortic transection and signs of greater autonomic derangement (heart rate variability parameters below the median and mean heart rate over the 75th percentile), possibly indicating more profound autonomic denervation, a lower incidence of postoperative atrial fibrillation was observed (22% vs. 54%). Conclusion: Transection of ascending aorta for repair of an aortic aneurysm did not confer any significant protective effect from postoperative atrial fibrillation in comparison to patients with intact ascending aorta. It could be speculated that a limited and heterogeneous cardiac denervation was produced by the intervention, creating an eletrophysiological substrate for the high incidence of postoperative atrial fibrillation observed.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382015000100012&lng=en&tlng=enSistema Nervoso AutônomoFibrilação AtrialAneurisma AórticoFrequência Cardíaca |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Leonida Compostella Nicola Russo Augusto D’Onofrio Tiziana Setzu Caterina Compostella Tomaso Bottio Gino Gerosa Fabio Bellotto |
spellingShingle |
Leonida Compostella Nicola Russo Augusto D’Onofrio Tiziana Setzu Caterina Compostella Tomaso Bottio Gino Gerosa Fabio Bellotto Abnormal heart rate variability and atrial fibrillation after aortic surgery Brazilian Journal of Cardiovascular Surgery Sistema Nervoso Autônomo Fibrilação Atrial Aneurisma Aórtico Frequência Cardíaca |
author_facet |
Leonida Compostella Nicola Russo Augusto D’Onofrio Tiziana Setzu Caterina Compostella Tomaso Bottio Gino Gerosa Fabio Bellotto |
author_sort |
Leonida Compostella |
title |
Abnormal heart rate variability and atrial fibrillation after aortic surgery |
title_short |
Abnormal heart rate variability and atrial fibrillation after aortic surgery |
title_full |
Abnormal heart rate variability and atrial fibrillation after aortic surgery |
title_fullStr |
Abnormal heart rate variability and atrial fibrillation after aortic surgery |
title_full_unstemmed |
Abnormal heart rate variability and atrial fibrillation after aortic surgery |
title_sort |
abnormal heart rate variability and atrial fibrillation after aortic surgery |
publisher |
Sociedade Brasileira de Cirurgia Cardiovascular |
series |
Brazilian Journal of Cardiovascular Surgery |
issn |
1678-9741 |
publishDate |
2015-02-01 |
description |
Introduction: Complete denervation of transplanted heart exerts protective effect against postoperative atrial fibrillation; various degrees of autonomic denervation appear also after transection of ascending aorta during surgery for aortic aneurysm. Objective: This study aimed to evaluate if the level of cardiac denervation obtained by resection of ascending aorta could exert any effect on postoperative atrial fibrillation incidence. Methods: We retrospectively analysed the clinical records of 67 patients submitted to graft replacement of ascending aorta (group A) and 132 with aortic valve replacement (group B); all episodes of postoperative atrial fibrillation occurred during the 1-month follow-up have been reported. Heart Rate Variability parameters were obtained from a 24-h Holter recording; clinical, echocardiographic and treatment data were also evaluated. Results: Overall, 45% of patients (group A 43%, group B 46%) presented at least one episode of postoperative atrial fibrillation. Older age (but not gender, abnormal glucose tolerance, ejection fraction, left atrial diameter) was correlated with incidence of postoperative atrial fibrillation. Only among a subgroup of patients with aortic transection and signs of greater autonomic derangement (heart rate variability parameters below the median and mean heart rate over the 75th percentile), possibly indicating more profound autonomic denervation, a lower incidence of postoperative atrial fibrillation was observed (22% vs. 54%). Conclusion: Transection of ascending aorta for repair of an aortic aneurysm did not confer any significant protective effect from postoperative atrial fibrillation in comparison to patients with intact ascending aorta. It could be speculated that a limited and heterogeneous cardiac denervation was produced by the intervention, creating an eletrophysiological substrate for the high incidence of postoperative atrial fibrillation observed. |
topic |
Sistema Nervoso Autônomo Fibrilação Atrial Aneurisma Aórtico Frequência Cardíaca |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382015000100012&lng=en&tlng=en |
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