By Jonathan S. Steinberg
Cardiac surgical procedure is played on millions of sufferers a yr, and will have a big necessary influence at the results of sufferers with coronary and valvular center illnesses. regardless of the favorable restoration of such a lot sufferers, a few could have their post-operative interval interrupted by means of the improvement of atrial traumatic inflammation, with a number of power problems together with stroke. excessive hazard subgroups may perhaps strengthen atrial traumatic inflammation in additional than part of circumstances, and sometimes regardless of competitive prophylactic measures. therapy of atrial traumatic inflammation and its aftermath may also upload days to the sanatorium remain of the cardiac surgical sufferer. In an period of competitive expense slicing and optimization of usage of healthiness care assets, the monetary impression of this arrhythmic hardship might be huge, immense.
Experimental reviews have resulted in a better realizing of the mechanism of atrial traumatic inflammation and power precipitating components within the cardiac surgical sufferer. Prophylactic efforts with beta-blockers, antiarrhythmic medicinal drugs and atrial pacing are getting used, or are being investigated in scientific trials. New tools of accomplishing urged cardioversion with minimum disruption of sufferer care, and prevention of the thromboembolic problems of atrial traumatic inflammation, also are vital healing projects. this article is designed to reduction overall healthiness care execs within the therapy in their sufferers in the restoration interval after cardiac surgical procedure, and to instigate extra examine efforts to restrict the prevalence of, and the issues following, this tenacious postoperative arrhythmia.
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Additional resources for Atrial Fibrillation after Cardiac Surgery
The role of the P wave duration as a predictor of postoperative atrial arrhythmia. Chest 1981;80:68-73. 42. Steinberg JS, Zelenkofske S, Wong SC, Gelemt M, Sciacca R, Menchavez E. Value of the P-wave signal-averaged ECG for predicting atrial fibrillation after cardiac surgery. Circulation 1993;88:2618-2622. 43. Klein M, Evans SJL, Blumberg S, Cataldo L, Bodenheimer MM. Use of P-wave-triggered, P-wave signal-averaged electrocardiogram to predict atrial fibrillation af\er coronary artery bypass surgery.
Atrial fibrillation after coronary artery bypass grafting is associated with sympathetic acfivation. Ann Thorac Surg 1995;60:1709-1715. 59. Frost L, Molgaard H, Christiansen EH, Jacobsen CJ, Pilegaard H, Thomsen PEB. Atrial ectopic activity and atrial fibrillation/fiutter after coronary artery bypass surgery; a case-base study controlling for the confounding from age, ()- blocker treatment, and the time distance from operafion. Int J Cardiol 1995;50:153-162. 60 Andrews TC, Reimold SC, Berlin JA, Antman EM.
Other potential explanations for reduced AF after minimally invasive CABG include less pericardial 23 manipulation and less postoperative pain. To this point, however, minimally invasive approaches to valve surgery have not impacted on the incidence of postoperative AF. In summary, for patients undergoing cardiac surgery, it seems likely the underlying cardiac pathology plays a prominent role in establishing the vulnerability to AF, and certain precipitants encountered during and following the operation act to induce the arrhythmia.
Atrial Fibrillation after Cardiac Surgery by Jonathan S. Steinberg