ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Claus Bartels
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bechtel, J.F. M.
Right arrow Articles by Bartels, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bechtel, J.F. M.
Right arrow Articles by Bartels, C.
Related Collections
Right arrow Electrophysiology - arrhythmias

Ann Thorac Surg 2003;75:1185-1188
© 2003 The Society of Thoracic Surgeons

Original article: cardiovascular

Low-energy cardioversion versus medical treatment for the termination of atrial fibrillation after CABG

J.F. Matthias Bechtel, MDa, Jan Felix Christiansen, MDa, Hans-Hinrich Sievers, MD, FETCSa*, Claus Bartels, MDa

a Department for Cardiac Surgery, University Hospital Luebeck, Luebeck, Germany

Accepted for publication October 29, 2002.

* Address reprint requests to Prof Sievers, Klinik fuer Herzchirurgie, Universitaetsklinikum Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
e-mail: sievers{at}medinf.mu-luebeck.de

BACKGROUND: Atrial fibrillation (AF) is the most frequent complication after cardiac surgery and can cause considerable morbidity. Low-energy cardioversion (LEC) using biatrial epicardial wires implanted during surgery has been shown to be effective and safe in conscious patients, but has not been directly compared with medical treatment so far. We therefore prospectively studied the efficacy of LEC in men 60 years of age and older.

METHODS: Sixteen patients (mean ± SD, 66.4 ± 5.4 years) were randomized to LEC and 32 patients (66.3 ± 5.0 years) to standarized medical treatment in the event of postoperative AF. Age, comorbidity, and surgical variables did not differ significantly between the groups.

RESULTS: After cardiac surgery, AF occurred in 6 patients (38%) assigned to LEC and in 11 patients assigned to medical treatment (34%; p = NS). Low-energy cardioversion restored sinus rhythm in all but 1 patient, and 1 patient in the LEC group had early recurrence of AF. All other patients in the LEC group had prompt and stable restoration of sinus rhythm. Medical treatment was associated with the restoration of sinus rhythm in all patients. Although the total time in AF was decreased significantly by LEC (median 5 minutes versus 22 hours; p = 0.037), the length of postoperative hospitalization was not (5.1 ± 1.4 days for the LEC group compared with 5.3 ± 1.6 days for controls).

CONCLUSIONS: Low-energy cardioversion significantly decreased the amount of time cardiac surgery patients spent in AF after the operation. Larger studies are needed to determine whether this new treatment modality has the ability to decrease morbidity associated with postoperative AF and is cost-effective.




This article has been cited by other articles:


Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
C. A. Palin, R. Kailasam, and C. W. Hogue Jr
Atrial Fibrillation After Cardiac Surgery: Pathophysiology and Treatment
Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2004; 8(3): 175 - 183.
[Abstract] [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
Copyright © 2003 by The Society of Thoracic Surgeons.