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Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation

BACKGROUND: Early postoperative atrial fibrillation (EPoAF) is associated with thromboembolic events, prolonged hospitalization, and development of late PoAF (LPoAF). It is, however, unknown if EPoAF can be predicted by intraoperative AF inducibility. The aims of this study are therefore to explore...

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Autores principales: Lanters, Eva A. H., Teuwen, Christophe P., Yaksh, Ameeta, Kik, Charles, van der Does, Lisette J. M. E., Mouws, Elisabeth M. J. P., Knops, Paul, van Groningen, Nicole J., Hokken, Thijmen, Bogers, Ad J. J. C., de Groot, Natasja M. S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5907553/
https://www.ncbi.nlm.nih.gov/pubmed/29525787
http://dx.doi.org/10.1161/JAHA.117.007879
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author Lanters, Eva A. H.
Teuwen, Christophe P.
Yaksh, Ameeta
Kik, Charles
van der Does, Lisette J. M. E.
Mouws, Elisabeth M. J. P.
Knops, Paul
van Groningen, Nicole J.
Hokken, Thijmen
Bogers, Ad J. J. C.
de Groot, Natasja M. S.
author_facet Lanters, Eva A. H.
Teuwen, Christophe P.
Yaksh, Ameeta
Kik, Charles
van der Does, Lisette J. M. E.
Mouws, Elisabeth M. J. P.
Knops, Paul
van Groningen, Nicole J.
Hokken, Thijmen
Bogers, Ad J. J. C.
de Groot, Natasja M. S.
author_sort Lanters, Eva A. H.
collection PubMed
description BACKGROUND: Early postoperative atrial fibrillation (EPoAF) is associated with thromboembolic events, prolonged hospitalization, and development of late PoAF (LPoAF). It is, however, unknown if EPoAF can be predicted by intraoperative AF inducibility. The aims of this study are therefore to explore (1) the value of intraoperative inducibility of AF for development of both EPoAF and LPoAF and (2) the predictive value of de novo EPoAF for recurrence of LPoAF. METHODS AND RESULTS: Patients (N=496, 75% male) undergoing cardiothoracic surgery for coronary and/or valvular heart disease were included. AF induction was attempted by atrial pacing, before extracorporeal circulation. All patients were on continuous rhythm monitoring until discharge to detect EPoAF. During a follow‐up period of 2 years, LPoAF was detected by ECGs and Holter recordings. Sustained AF was inducible in 56% of patients. There was no difference in patients with or without AF before surgery (P=0.159), or between different types of surgery (P=0.687). In patients without a history of AF, incidence of EPoAF and LPoAF was 37% and 2%, respectively. EPoAF recurred in 58% patients with preoperative AF, 53% developed LPoAF. There were no correlations between intraoperative inducibility and EPoAF or LPoAF (P>0.05). EPoAF was not correlated with LPoAF in patients without a history of AF (P=0.116), in contrast to patients with AF before surgery (P<0.001). CONCLUSIONS: Intraoperative AF inducibility does not predict development of either EPoAF or LPoAF. In patients with AF before surgery, EPoAF is correlated with LPoAF recurrences. This correlation is absent in patients without AF before surgery.
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spelling pubmed-59075532018-05-01 Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation Lanters, Eva A. H. Teuwen, Christophe P. Yaksh, Ameeta Kik, Charles van der Does, Lisette J. M. E. Mouws, Elisabeth M. J. P. Knops, Paul van Groningen, Nicole J. Hokken, Thijmen Bogers, Ad J. J. C. de Groot, Natasja M. S. J Am Heart Assoc Original Research BACKGROUND: Early postoperative atrial fibrillation (EPoAF) is associated with thromboembolic events, prolonged hospitalization, and development of late PoAF (LPoAF). It is, however, unknown if EPoAF can be predicted by intraoperative AF inducibility. The aims of this study are therefore to explore (1) the value of intraoperative inducibility of AF for development of both EPoAF and LPoAF and (2) the predictive value of de novo EPoAF for recurrence of LPoAF. METHODS AND RESULTS: Patients (N=496, 75% male) undergoing cardiothoracic surgery for coronary and/or valvular heart disease were included. AF induction was attempted by atrial pacing, before extracorporeal circulation. All patients were on continuous rhythm monitoring until discharge to detect EPoAF. During a follow‐up period of 2 years, LPoAF was detected by ECGs and Holter recordings. Sustained AF was inducible in 56% of patients. There was no difference in patients with or without AF before surgery (P=0.159), or between different types of surgery (P=0.687). In patients without a history of AF, incidence of EPoAF and LPoAF was 37% and 2%, respectively. EPoAF recurred in 58% patients with preoperative AF, 53% developed LPoAF. There were no correlations between intraoperative inducibility and EPoAF or LPoAF (P>0.05). EPoAF was not correlated with LPoAF in patients without a history of AF (P=0.116), in contrast to patients with AF before surgery (P<0.001). CONCLUSIONS: Intraoperative AF inducibility does not predict development of either EPoAF or LPoAF. In patients with AF before surgery, EPoAF is correlated with LPoAF recurrences. This correlation is absent in patients without AF before surgery. John Wiley and Sons Inc. 2018-03-10 /pmc/articles/PMC5907553/ /pubmed/29525787 http://dx.doi.org/10.1161/JAHA.117.007879 Text en © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Lanters, Eva A. H.
Teuwen, Christophe P.
Yaksh, Ameeta
Kik, Charles
van der Does, Lisette J. M. E.
Mouws, Elisabeth M. J. P.
Knops, Paul
van Groningen, Nicole J.
Hokken, Thijmen
Bogers, Ad J. J. C.
de Groot, Natasja M. S.
Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation
title Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation
title_full Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation
title_fullStr Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation
title_full_unstemmed Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation
title_short Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation
title_sort intraoperative inducibility of atrial fibrillation does not predict early postoperative atrial fibrillation
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5907553/
https://www.ncbi.nlm.nih.gov/pubmed/29525787
http://dx.doi.org/10.1161/JAHA.117.007879
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