Coronary Artery DiseaseUsefulness of Right Ventricular Dysfunction to Predict New-Onset Atrial Fibrillation Following Coronary Artery Bypass Grafting
Section snippets
Methods
Consecutive patients undergoing isolated CABG surgery without concomitant repair or replacement of the heart valves or great vessels were identified within the POSSE database. Data were obtained from 2 university-affiliated hospitals in the United States (Massachusetts General Hospital, Boston, Massachusetts, January 1, 2007 to December 31, 2009) and Canada (Jewish General Hospital, Montreal, Quebec, September 1, 2010 to July 11, 2011). From this cohort, subjects who had a digitally available
Results
The study population consisted of 768 patients (21.6% women), of which 197 patients (25.6%) developed postoperative AF. No patient was lost to follow-up for the primary outcome measure. Patients who developed postoperative AF were older (mean age 71.3 vs 64.9 years, p <0.001) and had a significantly higher rate of hypertension, chronic kidney disease, and congestive heart failure. They had slightly more number of diseased vessels and longer cardiopulmonary bypass times than patients without
Discussion
The present study has demonstrated that echocardiographic RV performance is predictive of postoperative AF in patients undergoing isolated CABG surgery. In particular, RV MPI, a composite measure of RV systolic and diastolic function, was additive to traditional risk factors for predicting postoperative AF.3 AF is one of the most commonly occurring arrhythmias after cardiac surgery and is associated with significant morbidity and mortality.8 In the general population, the pathophysiology of AF
Acknowledgment
We thank Marcia Leavitt, BA, David Crowell, BA, and Karen Lynch, BSN, for their invaluable help in obtaining clinical and echocardiographic data for this study. We also thank all of the cardiac sonographers at the Massachusetts General Hospital and Jewish General Hospital for their excellence in acquiring the echocardiographic images that made this study possible.
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Cited by (17)
Atrial Fibrillation Following Coronary Artery Bypass Graft: Where Do We Stand?
2022, Cardiovascular Revascularization MedicineIncidence and risk factors for new-onset atrial fibrillation following coronary artery bypass grafting: A systematic review and meta-analysis
2020, Intensive and Critical Care NursingCitation Excerpt :Amongst them, five studies included only patients undergoing first time CABG surgery (Daie et al., 2018; Erdil et al., 2014; Leal et al., 2012; Mendes et al., 1995; Straus et al., 2010) and two studies included patients undergoing both first and re-do CABG surgeries (Perrier et al., 2017; Sedrakyan et al., 2006). The remaining three studies (Sabzi et al., 2011; Shimony et al., 2014; Vlahou et al.,2016) did not clearly identify the participant surgical histories. The incidence data for each study is summarised in Table 2.
Relationship Between Right Ventricular Function and Atrial Fibrillation After Cardiac Surgery
2017, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Similarly, preexisting multiple clinical morbidities and symptomatic heart failure due to increased atrial pressure and volume overload or chronic neurohumoral stimulation, which cause chronic and progressive remodeling processes of the heart, have been reported as predisposing factors that might trigger POAF or enhance the substrates sustaining the arrhythmia.13–15 Despite different risk factors identified for the development of POAF after cardiac surgery, associations with these risk factors showed a large discrepancy among different studies.5,8,15,16 For example, body mass index was found to be an important determinant of POAF, whereas other studies, including the study presented here, failed to show this.15
Right Ventricular Anatomy, Function, and Echocardiographic Evaluation
2016, Practice of Clinical EchocardiographyIn-vivo deformation measurements of the human heart by 3D Digital Image Correlation
2015, Journal of BiomechanicsRole of epicardial fat in atrial fibrillation after coronary artery bypass surgery
2014, American Journal of Cardiology
Drs. Shimony and Afilalo contributed equally to this study.
This work was conducted with support from Harvard Catalyst, The Harvard Clinical and Translational Science Center (National Institutes of Health Award UL1 RR 025758 and financial contributions from Harvard University and its affiliated academic health care centers). The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, the National Center for Research Resources, or the National Institutes of Health (Boston, Massachusetts).
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