Original articleCardiovascularDetermination of Histopathologic Risk Factors for Postoperative Atrial Fibrillation in Cardiac Surgery
Section snippets
Material and Methods
One hundred patients undergoing elective CABG and in normal sinus rhythm preoperatively were enrolled in the study. Following approval to conduct the study from the ethical committee of the Marmara University School of Medicine, samples of right atrial appendage tissue (weighing at least 100 mg) from all patients were obtained prior to establishing cardiopulmonary bypass. A circular purse string suture was placed to the base of right atrial appendage for the venous cannulation in all patients.
Results
Postoperative AF was seen in 14 of 100 patients (14%). Mean time for the occurrence of postoperative AF was 45 ± 24.3 hours after cardiac surgery. In univariate analysis, the only independent clinical predictor for the risk of postoperative AF was found to be COPD (p = 0.014; Table 2). None of the independent clinical predictors created a statistical significance for postoperative AF in multivariate analysis. Preoperative beta-blocker therapy did not seem to prevent the occurrence of
Comment
Despite the improvements in myocardial protection, CPB and care of critically ill patients over the last 50 years in cardiac surgery, postoperative AF still remains one of the most common causes of morbidity after CABG [4, 7]. Identifying the patients at risk for postoperative AF after CABG would result in the reduction of both the incidence and undesired clinical consequences related to postoperative AF [13]. Prophylactic treatment of postoperative AF with anti-arrhythmic drugs is not without
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2013, International Journal of CardiologyCitation Excerpt :The detection of elevated serum levels of apoptosis mediators, including Fas in patients with AF, is another illustration of the importance of programmed cell death during AF [15]. The degree of myolysis and an increased apoptotic pattern could be significant predictors for the development of postoperative AF [16]. Indeed, atrial histology shows degenerative changes that may correlate with advanced age and left atrial enlargement.
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