|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2000; 35:1411-1415 © 2000 by the American College of Cardiology Foundation |
* Department of Cardiology, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium
Intensive Care Unit, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium
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.
| ||||||||||||||
This article has been cited by other articles:
|
|
 |
|
  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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 M. A. Albert and E. M. Antman Preoperative Evaluation for Cardiac Surgery Card. Surg. Adult, January 1, 2003; 2(2003): 235 - 248. [Full Text]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
