| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2000;69:1057-1063
© 2000 The Society of Thoracic Surgeons
a Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
b Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
Address reprint requests to Dr Chung, Department of Cardiology, The Cleveland Clinic Foundation, 9500 Euclid Ave, Desk F-15, Cleveland, OH 44195-5245
e-mail: chungm{at}ccf.org
Background. Atrial pacing is often used empirically to suppress atrial ectopy and prevent atrial fibrillation after coronary artery bypass grafting.
Methods. To determine whether atrial overdrive pacing reduces atrial fibrillation and atrial ectopy after coronary artery bypass grafting, 100 patients were randomized to no atrial pacing (Control) versus AAI pacing at 10 beats/min or more above the resting heart rate (Paced), started by postoperative day 1 and continued through day 4. Major end points were new atrial fibrillation and frequency of atrial ectopy during the first 4 days after coronary artery bypass grafting.
Results. Atrial fibrillation occurred by day 4 in 13 of 51 (25.5%) Paced and in 14 of 49 (28.6%) Control patients, p = 0.90. Control patients who developed atrial fibrillation had significantly more atrial ectopy than those who did not. Atrial ectopy was paradoxically more frequent in the Paced group (2,106 ± 428 versus 866 ± 385 per 24 hours, p = 0.0001). Loss of capture, sensing, and consistent atrial pacing occurred frequently during atrial pacing.
Conclusions. Contrary to prevailing opinion and practice, postoperative atrial overdrive pacing significantly increases atrial ectopy and does not reduce the likelihood of atrial fibrillation.
This article has been cited by other articles:
|
|
 |
|
  R. Shrivastava, B. Smith, D. Caskey, and P. Reddy Atrial Fibrillation After Cardiac Surgery: Does Prophylactic Therapy Decrease Adverse Outcomes Associated With Atrial Fibrillation J Intensive Care Med, January 1, 2009; 24(1): 18 - 25. [Abstract] [PDF]
|
|
|
|
 |
|
 D. C. Burgess, M. J. Kilborn, and A. C. Keech Interventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis Eur. Heart J., December 1, 2006; 27(23): 2846 - 2857. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 J. Melo, P. Voigt, B. Sonmez, M. Ferreira, M. Abecasis, M. Rebocho, A. Timoteo, C. Aguiar, S. Tansal, H. Arbatli, et al. Ventral cardiac denervation reduces the incidence of atrial fibrillation after coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 511 - 516. [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]
|
|
|
|
 |
|
 M. Funk, S. B. Richards, J. Desjardins, C. Bebon, and H. Wilcox Incidence, Timing, Symptoms, and Risk Factors for Atrial Fibrillation After Cardiac Surgery Am. J. Crit. Care., September 1, 2003; 12(5): 424 - 433. [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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 A. Shimizu and O. A. Centurion Electrophysiological properties of the human atrium in atrial fibrillation Cardiovasc Res, May 1, 2002; 54(2): 302 - 314. [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]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
