Advertisement






Click here for more guidelines.
CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2000; 35:1411-1415
© 2000 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Blommaert, D.
Right arrow Articles by De Roy, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Blommaert, D.
Right arrow Articles by De Roy, L.

CLINICAL STUDIES

Effective prevention of atrial fibrillation by continuous atrial overdrive pacing after coronary artery bypass surgery

Dominique Blommaert, MD*, Manuel Gonzalez, MD{dagger}, Joseph Mucumbitsi, MD*, Olivier Gurné, MD, PhD*, Patrick Evrard, MD{dagger}, Michel Buche, MD{ddagger}, Yves Louagie, MD, PhD{ddagger}, Philippe Eucher, MD{ddagger}, Jacques Jamart, MD§, Etienne Installé, MD{dagger} and Luc De Roy, MD*

* Department of Cardiology, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium
{dagger} Intensive Care Unit, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium
{ddagger} Cardiovascular Surgery, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium
§ Biostatistics Unit, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium

Manuscript received April 22, 1999; revised manuscript received September 22, 1999, accepted February 2, 2000.

Reprint requests and correspondence: Dr. Dominique Blommaert, Cardiology Department, Cliniques Universitaires de Mont-Godinne, Avenue Jean Thérasse, 1, B-5530 Yvoir, Belgium
dominique.blommaert{at}card.ucl.ac.be

OBJECTIVES

The present study was aimed to evaluate the efficacy of a specific algorithm with continuous atrial dynamic overdrive pacing to prevent atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery.

BACKGROUND

Atrial fibrillation occurs in 30% to 40% of patients after cardiac surgery with a peak incidence on the second day. It still represents a challenge for postoperative prevention and treatment and may have medical and cost implications.

METHODS

Ninety-six consecutive patients undergoing CABG for severe coronary artery disease and in sinus rhythm without antiarrhythmic therapy on the second postoperative day were randomized to have or not 24 h of atrial pacing through temporary epicardial wires using a permanent dynamic overdrive algorithm. Holter ECGs recorded the same day in both groups were analyzed to detect AF occurrence.

RESULTS

No difference was observed in baseline data between the two study groups, particularly for age, male gender, history of AF, ventricular function, severity of coronary artery disease, preoperative beta-adrenergic blocking agent therapy or P-wave duration. The incidence of AF was significantly lower (p = 0.036) in the paced group (10%) compared with control subjects (27%). Multivariate analysis showed AF incidence to increase with age (p = 0.051) but not in patients with pacing (p = 0.078). It decreased with a better left ventricular ejection fraction only in conjunction with atrial pacing (p = 0.018).

CONCLUSIONS

We conclude that continuous atrial pacing with an algorithm for dynamic overdrive reduces significantly incidence of AF the second day after CABG surgery, particularly in patients with preserved left ventricular function.

Abbreviations and Acronyms
  AF = atrial fibrillation
  APB = atrial premature beats
  CABG = coronary artery bypass graft
  LVEF = left ventricular ejection fraction
  PAP = pulmonary artery pressure
  PCWP = pulmonary capillary wedge pressure




This article has been cited by other articles:


Home page
ChestHome page
C. W. Hogue Jr., L. L. Creswell, D. D. Gutterman, and L. A. Fleisher
Epidemiology, Mechanisms, and Risks: American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac Surgery
Chest, August 1, 2005; 128(2_suppl): 9S - 16S.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
W. H. Maisel and A. E. Epstein
The Role of Cardiac Pacing: American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac Surgery
Chest, August 1, 2005; 128(2_suppl): 36S - 38S.
[Abstract] [Full Text] [PDF]


Home page
SEMIN CARDIOTHORAC VASC ANESTHHome page
R. Kailasam, C. A. Palin, and C. W. Hogue Jr
Atrial Fibrillation After Cardiac Surgery: An Evidence-Based Approach to Prevention
Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2005; 9(1): 77 - 85.
[Abstract] [PDF]


Home page
ICVTSHome page
A. Ronald and J. Dunning
Bi-atrial pacing significantly reduces the Incidence of atrial fibrillation post cardiac surgery
Interactive CardioVascular and Thoracic Surgery, February 1, 2005; 4(1): 33 - 40.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
H. Kohno, T. Koyanagi, H. Kasegawa, and M. Miyazaki
Three-Day Magnesium Administration Prevents Atrial Fibrillation After Coronary Artery Bypass Grafting
Ann. Thorac. Surg., January 1, 2005; 79(1): 117 - 126.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
T. Hakala, A. J.M. Valtola, A. K. Turpeinen, A. E. Hedman, R. E.U. Vuorenniemi, J. M. Karjalainen, I. S. Vajanto, J. Kouri, P. A. Jaakkola, and J. E.K. Hartikainen
Right atrial overdrive pacing does not prevent atrial fibrillation after coronary artery bypass surgery
Europace, January 1, 2005; 7(2): 170 - 174.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
R A Archbold and R J Schilling
Atrial pacing for the prevention of atrial fibrillation after coronary artery bypass graft surgery: a review of the literature
Heart, February 1, 2004; 90(2): 129 - 133.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
A. Puglisi, G. Altamura, F. Capestro, B. Castaldi, G. Critelli, S. Favale, L. Pavia, and G. Pettinati
Impact of Closed-Loop Stimulation, overdrive pacing, DDDR pacing mode on atrial tachyarrhythmia burden in Brady-Tachy Syndrome: A randomized study
Eur. Heart J., November 1, 2003; 24(21): 1952 - 1961.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
D. Amar, H. Zhang, S. Miodownik, and A. H. Kadish
Competing autonomic mechanisms precedethe onset of postoperative atrial fibrillation
J. Am. Coll. Cardiol., October 1, 2003; 42(7): 1262 - 1268.
[Abstract] [Full Text] [PDF]


Home page
Asian Cardiovasc. Thorac. Ann.Home page
W.-K. Au, S.-W. Chiu, M.-P. Sun, L.-C. Cheung, and L.-C. Cheng
Biatrial Pacing to Prevent Atrial Fibrillation After Coronary Artery Bypass
Asian Cardiovasc Thorac Ann, September 1, 2003; 11(3): 222 - 225.
[Abstract] [Full Text]


Home page
HeartHome page
A Queiroga, H J Marshall, M Clune, and M D Gammage
Ablate and pace revisited: long term survival and predictors of permanent atrial fibrillation
Heart, September 1, 2003; 89(9): 1035 - 1038.
[Abstract] [Full Text] [PDF]


Home page
Card Surg AdultHome page
M. A. Albert and E. M. Antman
Preoperative Evaluation for Cardiac Surgery
Card. Surg. Adult, January 1, 2003; 2(2003): 235 - 248.
[Full Text]


Home page
HeartHome page
A D Taylor, J G Groen, S L Thorn, C T Lewis, and A J Marshall
New insights into onset mechanisms of atrial fibrillation and flutter after coronary artery bypass graft surgery
Heart, December 1, 2002; 88(5): 499 - 504.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
E. Crystal, S. J. Connolly, K. Sleik, T. J. Ginger, and S. Yusuf
Interventions on Prevention of Postoperative Atrial Fibrillation in Patients Undergoing Heart Surgery: A Meta-Analysis
Circulation, July 2, 2002; 106(1): 75 - 80.
[Abstract] [Full Text] [PDF]


Home page
NEJMHome page
J. M. Cooper, M. S. Katcher, and M. V. Orlov
Implantable Devices for the Treatment of Atrial Fibrillation
N. Engl. J. Med., June 27, 2002; 346(26): 2062 - 2068.
[Full Text] [PDF]


Home page
Cardiovasc ResHome page
A. Goette, G. Juenemann, B. Peters, H. U. Klein, A. Roessner, C. Huth, and C. Rocken
Determinants and consequences of atrial fibrosis in patients undergoing open heart surgery
Cardiovasc Res, May 1, 2002; 54(2): 390 - 396.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
R. L. Wurdeman, A. N. Mooss, S. M. Mohiuddin, and T. L. Lenz
Amiodarone vs Sotalol as Prophylaxis Against Atrial Fibrillation/Flutter After Heart Surgery* : A Meta-Analysis
Chest, April 1, 2002; 121(4): 1203 - 1210.
[Abstract] [Full Text] [PDF]


Home page
ANN INTERN MEDHome page
W. H. Maisel, J. D. Rawn, and W. G. Stevenson
Atrial Fibrillation after Cardiac Surgery
Ann Intern Med, December 18, 2001; 135(12): 1061 - 1073.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. C. Daubert and P. Mabo
Atrial pacing for the prevention of postoperative atrial fibrillation: how and where to pace?
J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1423 - 1427.
[Full Text] [PDF]



 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement