scholarly journals Dexmedetomidine versus propofol in reducing atrial fibrillation after cardiac surgery

2022 ◽  
Vol 38 (1) ◽  
pp. 72-77
Author(s):  
Ola Abdallah ◽  
Mahmoud I. Salem ◽  
Mohammad Gomaa
2014 ◽  
Vol 17 (1) ◽  
pp. 54 ◽  
Author(s):  
Nan Cheng ◽  
Changqing Gao

Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. Many studies have reported an incidence of 20%-40% in patients undergoing open heart surgery, and the peak incidence usually occurs between the postoperative days [Fuller 1989; Aranki 1996; Svedjeholm 2000; Maisel 2001]. AF is commonly self-limited and rarely results in postoperative death. However, postoperative AF (POAF) is often associated with complications, including stroke, heart failure, prolonged hospital stay, and increased costs [Maisel 2001; Bramer 2010]. Many pharmacological methods have been used to prevent this complication, and beta-blockers, which have been investigated in several studies, have demonstrated effectiveness [Ali 1997; Connolly 2003; Crystal 2004; Halonen 2006; Imren 2007]. There is currently a consensus in the use of beta-blockers for the prevention of POAF. However, whether the effect of beta-blockers on POAF is dose dependent has not been widely studied [Coleman 2004; Lucio 2004]. In addition, patients with different racial backgrounds have a different response to metoprolol based on body shape. In addition, the CYP2D6 genotypes are different among white and Asian patients. In this study dose-dependent prophylactic effects of beta-blockers, which were obtained in a single center.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Lauritzen ◽  
H.J Vodstrup ◽  
T.D Christensen ◽  
M Onat ◽  
R Christensen ◽  
...  

Abstract Background Following catheter ablation for atrial fibrillation (AF), CHADS2 and CHA2DS2-VASc have utility in predicting long-term outcomes. However, it is currently unknown if the same holds for patients undergoing surgical ablation. Purpose To determine whether CHADS2 and CHA2DS2-VASc predict long-term outcomes after surgical ablation in concomitance with other cardiac surgery. Methods In this prospective, follow-up study, we included patients who underwent biatrial ablation - or pulmonary vein isolation procedure concomitantly with other cardiac surgery between 2004 and 2018. CHADS2 and CHA2DS2-VASc scores were assessed prior to surgery and categorized in groups as 0–1, 2–4 or ≥5. Outcomes were death, AF, and AF-related death. Follow-up was ended in April 2019. Results A total of 587 patients with a mean age of 68.7±0.4 years were included. Both CHADS2 and CHA2DS2-VASc scores were predictors of survival p=0.005 and p<0.001, respectively (Figure). For CHADS2, mean survival times were 5.9±3.7 years for scores 0–1, 5.0±3.0 years for scores 2–4 and 4.3±2.6 years for scores ≥5. For CHA2DS2-VASc mean survival times were 7.3±4.0 years for scores 0–1, 5.6±2.9 years for scores 2–4 and 4.8±2.1 years for scores ≥5. The incidence of death was 20.1% for CHADS2 0–1, 24.8% for CHADS2 2–4, and 35.3% for CHADS2 ≥5, p=0.186. The incidence of AF was 50.2% for CHADS2 0–1, 47.9% for CHADS2 2–4, and 76.5% for CHADS2 ≥5, p=0.073. The incidence of AF related death was 13.0% for CHADS2 0–1, 16.8% for CHADS2 2–4, and 35.3% for CHADS2 ≥5, p=0.031. The incidence of death was 16.8% for CHA2DS2-VASc 0–1, 26.2% for CHA2DS2-VASc 2–4, and 45.0% for CHA2DS2-VASc ≥5, p=0.001. The incidence of AF was 49.6% for CHA2DS2-VASc 0–1, 52.5% for CHA2DS2-VASc 2–4, and 72.5% for CHA2DS2-VASc ≥5, p=0.035. The incidence of AF related death was 12.2% for CHA2DS2-VASc 0–1, 16.0% for CHA2DS2-VASc 2–4, and 42.5% for CHA2DS2-VASc ≥5, p<0.001. Conclusion Both CHADS2 and CHA2DS2-VASc scores predict long-term outcomes after surgical ablation for AF. However, CHA2DS2-VASc was superior in predicting death, AF, and AF-related death. Survival curves Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 13 (1) ◽  
pp. 133-140
Author(s):  
Jason D. Matos ◽  
Frank W. Sellke ◽  
Peter Zimetbaum

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