• Atrial fibrillation
• CHA(2)DS(2)-VASc score
• Cardiac arrhythmia
• Coronary-artery bypass grafting
• Hospitalization

• Humans
• Coronary Artery Bypass/trends
• Patient Readmission/statistics & numerical data
• Patient Readmission/trends
• Female
• Male
• Aged
• Databases, Factual
• Middle Aged
• United States/epidemiology
• Postoperative Complications/epidemiology
• Risk Assessment/methods
• Predictive Value of Tests
• Treatment Outcome
• Atrial Fibrillation/surgery
• Atrial Fibrillation/epidemiology
• Health Resources/statistics & numerical data
• Health Resources/economics
• Retrospective Studies
• Risk Factors
• Length of Stay/trends
• Length of Stay/statistics & numerical data

• Atrial fibrillation
• Coronary artery bypass grafting
• Empagliflozin
• SGLT2 inhibitor
• Ventricular arrhythmia

• Humans
• Atrial Fibrillation/prevention & control
• Atrial Fibrillation/etiology
• Coronary Artery Bypass/adverse effects
• Glucosides/therapeutic use
• Male
• Double-Blind Method
• Female
• Middle Aged
• Benzhydryl Compounds/therapeutic use
• Aged
• Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
• C-Reactive Protein/metabolism
• C-Reactive Protein/analysis
• Postoperative Complications/prevention & control
• Postoperative Complications/etiology

• atrial fibrillation
• exosomes
• extracellular vesicles
• postoperative

• Atrial Fibrillation/drug therapy
• Colchicine/pharmacology
• Colchicine/therapeutic use
• Amiodarone/pharmacology
• Amiodarone/therapeutic use
• Animals
• Rats
• Rats, Sprague-Dawley
• Fibrosis
• Anti-Arrhythmia Agents/pharmacology
• Anti-Arrhythmia Agents/therapeutic use
• Humans
• Male
• Heart Atria/drug effects
• Heart Atria/pathology
• Inflammation/drug therapy
• Postoperative Complications/prevention & control
• Anti-Inflammatory Agents/pharmacology
• Anti-Inflammatory Agents/therapeutic use
• Pericarditis/drug therapy
• Extracellular Vesicles/drug effects
• Disease Models, Animal
• Cells, Cultured

• Antiarrhythmic
• Cardioversion
• Case cancellation
• Defibrillation
• Dysrhythmia
• Paroxysmal atrial fibrillation
• Postoperative atrial fibrillation
• Silent atrial fibrillation

• Humans
• Atrial Fibrillation/diagnosis
• Atrial Fibrillation/therapy
• Electric Countershock
• Ambulatory Care Facilities
• Risk Factors
• Anesthetics

• atrioventricular (AV) block
• complete heart block (CHB)
• conduction defect (CD)
• coronary artery bypass grafting (CABG)
• permanent pacemaker (PPM)
• temporary pacemaker
• temporary pacing

• Becker muscular dystrophy
• Dilated cardiomyopathy
• Heart failure
• Systematic review

• Adult
• Cardiomyopathy, Dilated/diagnosis
• Heart Failure
• Humans
• Male
• Muscular Dystrophy, Duchenne/diagnosis
• Stroke Volume
• Ventricular Function, Left

• fiber Bragg grating sensors
• finite element analysis
• hyperthermal tissue damage
• myocardial anisotropy
• radiofrequency ablation

Background: Postoperative atrial fibrillation (POAF) results in a longer hospital stay and excess mortality. However, whether POAF would increase stroke rate has been debated for years. When and how long should anticoagulation be used to prevent stroke are unknown. In the study, we planned to investigate the clinical demographics and long-term outcomes of POAF after cardiac surgery in a single-center cohort.

Methods: The cohort study used a database from National Taiwan University Hospital, a single tertiary medical center in Taiwan, between 2007 and 2017, to identify patients with prior normal sinus rhythm developing POAF after cardiac surgery. Patients without POAF after cardiac surgery were used as controls. Propensity score matching with 1:1 ratio and Cox regression models were employed to estimate the risk of transient ischemic accident (TIA) or ischemic stroke.

Results: From 2007 to 2017, a total of 8,374 patients received open-heart surgery, in which 1,585 patients with a history of AF were excluded. The overall incidence of TIA/ischemic stroke was 3.9% in a median 9.2-years of follow-up. After propensity matching, 1,965 matched paired subjects were included for analysis. Postoperative atrial fibrillation was associated with an increased risk of future AF [Hazard ratio (HR) 1.40, 95% confidence interval (95%CI) = 1.09–1.79, p = 0.008] and heart failure (HF) hospitalization (HR 1.58, 95%CI 1.23–2.04, p < 0.001); however, POAF did not significantly correlate with the risk of TIA/ischemic stroke (HR 1.17, 95%CI 0.85–1.60, p = 0.043). Kaplan-Meier analysis showed that POAF was a significant predictor for future AF, HF hospitalization, and overall mortality, but not for TIA/ischemic stroke.

Conclusion: In the Asian population, POAF after cardiac surgery increased the risk of future AF, HF, and overall mortality, but was not associated with future TIA/ischemic stroke.

• atrial fibrillation
• coronary artery bypass grafting
• open heart surgery
• postoperative atrial fibrillation
• stroke

• Animals
• Atrioventricular Node/anatomy & histology
• Sheep/anatomy & histology
• Sinoatrial Node/anatomy & histology

• R01 HL135077 NHLBI NIH HHS
• R56 HL128813 NHLBI NIH HHS
• National Heart, Lung, and Blood Institute

Atrial fibrillation (AF) is a failure that is observed in heart disease and is also known to be the most common heart rhythm disturbance post coronary artery bypass surgery. Although AF is considered a transient problem, it is usually accompanied with a variety of complications and morbidity for patients and may result in death. In the present study, pre- and post-operative considerable factors which may increase the risk and mortality of AF, and possible treatments have been concisely reviewed.

• atrial fibrillation
• cardiac surgery
• mortality
• prophylaxis
• risk factor

• arrhythmia
• coronary artery bypass grafting
• hypomagnesaemia
• magnesium sulphate

• Aged
• Arrhythmias, Cardiac/drug therapy
• Arrhythmias, Cardiac/epidemiology
• Arrhythmias, Cardiac/etiology
• Coronary Artery Bypass/adverse effects
• Coronary Artery Bypass/methods
• Coronary Artery Disease/blood
• Coronary Artery Disease/mortality
• Coronary Artery Disease/surgery
• Follow-Up Studies
• Humans
• Incidence
• Magnesium/blood
• Magnesium Sulfate/therapeutic use
• Male
• Middle Aged
• Postoperative Complications/blood
• Postoperative Complications/epidemiology
• Postoperative Complications/prevention & control
• Reference Values
• Risk Assessment
• Survival Rate
• Treatment Outcome

• Atrial fibrillation
• Atrial flutter
• Beta blocker
• Cardiac surgery
• New onset
• Prophylaxis

• Bypass surgery
• Continuous rhythm registration
• Coronary disease
• Electrocardiogram
• Ventricular arrhythmia

Atrial fibrillation is a common arrhythmia following coronary artery bypass graft surgery. Its incidence can range from 10 to 60% of patients undergoing coronary artery bypass graft. This rhythm can result in shorter or longer intervals between beats.

Medical records of 143 patients from the Queen’s Medical Center, Kuakini Medical Center, Saint Francis Medical Center, and Straub Hospital and Clinic, all of which are located in Honolulu, Hawaii were reviewed. An additional 39 records of patients who did not develop these complications were also reviewed as a control group. Patients were selected according to the ICD codes for atrial fibrillation/flutter and coronary artery bypass graft. Both anomalies can lead to increased health care costs, morbidity, and mortality. In this study, possible predisposing factors to these complications were investigated. The time of onset, weight gain, elapsed time, fluid status (in/out), hematocrit, and drug regimens were compared between the two groups.

The differences in weight gain, fluid status, and hematocrit between the groups were not significant. There were a total of 17 different drugs prescribed to the group as a whole but not every patient received the same regimen.

Atrial fibrillation and flutter were found to be more common in males, particularly between the ages of 60 and 69 years. There were no other significant findings.

• Acute myocardial infarction
• arrhythmias
• clinical electrophysiology
• drugs
• peripheral vascular disease

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression (from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and heart failure and the congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category scores as well as biomarkers related to inflammation may also add important information on this topic. There is now increasing evidence that even in patients with so-called lone or idiopathic AF, the arrhythmia is the manifestation of a structural atrial disease which has recently been defined and described as fibrotic atrial cardiomyopathy. Fibrosis results from a broad range of factors related to AF inducing pathologies such as cell stretch, neurohumoral activation, and oxidative stress. The extent of fibrosis as detected either by late gadolinium enhancement-magnetic resonance imaging or electroanatomic voltage mapping may guide the therapeutic approach based on the arrhythmia substrate. The knowledge of these risk factors may not only delay arrhythmia progression, but also reduce the arrhythmia burden in patients with first detected AF. The present review highlights on the conventional and novel risk factors of development and progression of AF.

• Atrial fibrillation
• Development
• Progression
• Risk factors
• Inflammation
• Fibrosis

• cardiac surgery
• left atrial appendage velocity
• postoperative atrial fibrillation
• transesophageal echocardiography

Disturbances of the cardiac conduction system are frequent in the postoperative period of coronary artery bypass surgery. They are mostly reversible and associated with some injury of the conduction tissue, caused by the ischemic heart disease itself or by perioperative factors.

Primary: investigate the association between perioperative factors and the emergence of atrioventricular block in the postoperative period of coronary artery bypass surgery. Secondary: determine the need for temporary pacing and of a permanent pacemaker in the postoperative period of coronary artery bypass surgery and the impact on hospital stay and hospital mortality.

Analysis of a retrospective cohort of patients submitted to coronary artery bypass surgery from the database of the Postoperative Heart Surgery Unit of the Sao Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul, using the logistic regression method.

In the period from January 1996 to December 2012, 3532 coronary artery bypass surgery were carried out. Two hundred and eighty-eight (8.15% of the total sample) patients had atrioventricular block during the postoperative period of coronary artery bypass surgery, requiring temporary pacing. Eight of those who had atrioventricular block progressed to implantation of a permanent pacemaker (0.23% of the total sample). Multivariate analysis revealed a significant association of atrioventricular block with age above 60 years (OR=2.34; CI 95% 1.75-3.12; P<0.0001), female gender (OR=1.37; CI 95% 1.06-1.77; P=0.015), chronic kidney disease (OR=2.05; CI 95% 1.49-2.81; P<0.0001), atrial fibrillation (OR=2.06; CI 95% 1.16-3.66; P=0.014), functional class III and IV of the New York Heart Association (OR=1.43; CI 95% 1.03-1.98; P=0.031), perioperative acute myocardial infarction (OR=1.70; CI 95% 1.26-2.29; P<0.0001) and with the use of the intra-aortic balloon in the postoperative period of coronary artery bypass surgery (OR=1.92; CI 95% 1.21-3.05; P=0.006). The presence of atrioventricular block resulted in a significant increase in mortality (17.9% vs. 7.3% in those who did not develop atrioventricular block) (OR=2.09; CI 95% 1.46-2.99; P<0.0001) and a longer hospital stay (12.75 days x 10.53 days for those who didn't develop atrioventricular block) (OR=1.01; CI 95% 1.00-1.02; P=0.01).

In most cases, atrioventricular block in the postoperative period of coronary artery bypass surgery is transient and associated with several perioperative factors: age above 60 years, female sex, chronic kidney disease, atrial fibrillation, New York Heart Association functional class III or IV, perioperative acute myocardial infarction and use of an intra-aortic balloon. Its occurrence prolongs hospitalization and, above all, doubles the risk of mortality.

Randomized studies of implantable cardioverter defibrillators (ICD) have excluded sudden cardiac death survivors who had revascularization before or after an arrhythmic event. To evaluate the role of ICD and the effects of clinical variables including degree of revascularization, we studied cardiac surgery patients who had an ICD implanted for sustained perioperative ventricular arrhythmias.

The electronic database for Southern California Kaiser Foundation hospitals was searched for patients who had cardiac surgery between 1999 and 2005 and an ICD implanted within 3 months of surgery. One hundred sixty‐four patients were identified; 93/164 had an ICD for sustained pre‐ or postoperative ventricular tachycardia or fibrillation requiring resuscitation. Records were reviewed for the following: presenting arrhythmia, ejection fraction, and degree of revascularization. The primary end point was total mortality (TM) and/or appropriate ICD therapy (ICD‐T), and secondary end points are TM and ICD‐T. During the mean follow up of 49 months, the primary endpoint of TM+ICD‐T and individual end points of TM and ICD‐T were observed in 52 (56%), 35 (38%), and 28 (30%) patients, respectively, with 55% of TM, and 23% of ICD‐T occurring within 2 years of implant. In multivariate risk analysis, none of the following was associated with any of the end points: incomplete revascularization, presenting ventricular arrhythmia, and timing of arrhythmias.

Our data supports the recent guidelines for ICD in this cohort of patients, as the presence of irreversible substrate and triggers of ventricular arrhythmias, cannot be reliably excluded even with complete revascularization. Further studies are needed to understand this complex group of patients.

• implantable defibrillator
• perioperative ventricular arrhythmias
• revascularization

Pericardial effusion and atrial fibrillation occur commonly after coronary artery surgery.

A prospective randomized clinical trial was conducted to evaluate the effects of posterior pericardiotomy on the occurrence of pericardial effusion, tamponade, and atrial fibrillation.

The study group consisted of 96 patients (77 male and 19 female) at a mean age of 58.1 ± 9.8 years. The patients were randomly assigned to one of three study groups: patients undergoing posterior pericardiotomy (group I, n = 30), controls (group II, n = 33), and patients with additional posterior pericardial drainage tubes (28 mm) who did not undergo posterior pericardiotomy (group III, n = 33).

Postoperative hospitalization (p = 0.03; 11.56 ± 10.64) and reoperation due to tamponade (p = 0.019; 12.1%) were significantly higher in group II. Extensive pericardial effusions were detected in one patient on the first postoperative day (group II, n = 1), in one patient on the fifth postoperative day (group III, n = 1), and in one patient on the 30^th day after the operation (group III, n = 1). Pericardial effusion exhibited regression in group I on postoperative day 30 (p = 0.028). A higher rate of postoperative atrial fibrillation was noted in group I, but no significant differences were found between the groups with regard to postoperative atrial fibrillation.

Patients who did not undergo posterior pericardiotomy or did not receive posterior chest tubes exhibited residual pericardial effusion, required longer hospitalization, and had to be reoperated due to tamponade. Both posterior pericardiotomy and the use of posterior tubes are effective in the early postoperative period.

• atrial fibrillation
• cardiac tamponade
• pericardial effusion
• posterior pericardiotomy

• chronic kidney disease
• off-pump coronary artery bypass
• ventricular arrhythmia

Arrhythmias are a known complication after cardiac surgery and represent a major cause of morbidity, increased length of hospital stay, and economic costs. However, little is known about incidence, risk factors, and treatment of early postoperative arrhythmias. Both tachyarrhythmias and bradyarrhythmias can present in the postoperative period. In this setting, atrial fibrillation is the most common heart rhythm disorder. Postoperative atrial fibrillation is often self-limiting, but it may require anticoagulation therapy and either a rate or rhythm control strategy. However, ventricular arrhythmias and conduction disturbances can also occur. Sustained ventricular arrhythmias in the recovery period after cardiac surgery may warrant acute treatment and long-term preventive strategy in the absence of reversible causes. Transient bradyarrhythmias may be managed with temporary pacing wires placed at surgery, but significant and persistent atrioventricular block or sinus node dysfunction can occur with the need for permanent pacing. We provide a complete and updated review about mechanisms, risk factors, and treatment strategies for the main postoperative arrhythmias.

• Arrhythmias
• coronary artery bypass
• intra-aortic balloon pump
• ischemic heart disease
• myocardial infarction
• postoperative complications

• Atrial Fibrillation/epidemiology
• Atrial Fibrillation/etiology
• Coronary Artery Bypass/adverse effects
• Female
• Humans
• Incidence
• Length of Stay/statistics & numerical data
• Male
• Middle Aged
• Pericardial Effusion/epidemiology
• Pericardial Effusion/etiology
• Pericardiectomy/methods
• Perioperative Care
• Turkey/epidemiology

Postoperative atrial fibrillation (POAF) is common among surgical patients and associated with a worse outcome. Pathophysiology of POAF is not fully disclosed, and several perioperative factors could be involved. Direct cardiac stimulation from perioperative use of catecholamines or increased sympathetic outflow from volume loss/anaemia/pain may play a role. Metabolic alterations, such as hypo-/hyperglycaemia and electrolyte disturbances, may also contribute to POAF. Moreover, inflammation, both systemic and local, may play a role in its pathogenesis. Strategies to prevent POAF aim at reducing its incidence and ameliorate global outcome of surgical patients. Nonpharmacological prophylaxis includes an adequate control of postoperative pain, the use of thoracic epidural analgesia, optimization of perioperative oxygen delivery, and, possibly, modulation of surgery-associated inflammatory response with immunonutrition and antioxidants. Perioperative potassium and magnesium depletion should be corrected. The impact of those interventions on patients outcome needs to be further investigated.

• Age Factors
• Amiodarone/therapeutic use
• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors/therapeutic use
• Anti-Arrhythmia Agents/therapeutic use
• Atrial Fibrillation/diagnosis
• Atrial Fibrillation/epidemiology
• Atrial Fibrillation/etiology
• Atrial Fibrillation/physiopathology
• Atrial Fibrillation/prevention & control
• Calcium Channel Blockers/therapeutic use
• Cardiac Pacing, Artificial
• Cardiac Surgical Procedures/adverse effects
• Coronary Artery Bypass/adverse effects
• Digoxin/therapeutic use
• Heart Conduction System/physiopathology
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
• Magnesium Sulfate/therapeutic use
• Postoperative Complications/diagnosis
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Postoperative Complications/physiopathology
• Postoperative Complications/prevention & control
• Practice Guidelines as Topic
• Randomized Controlled Trials as Topic
• Recurrence
• Risk Factors
• Sex Factors
• Sotalol/therapeutic use
• Survival Analysis
• Thoracic Surgical Procedures/adverse effects

• Adrenergic beta-Antagonists/therapeutic use
• Aged
• Atrial Fibrillation/prevention & control
• Coronary Artery Bypass/adverse effects
• Diabetes Mellitus/physiopathology
• Electrocardiography
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prospective Studies
• Sympathetic Nervous System/physiopathology
• Vagus Nerve/physiopathology

• Adrenergic beta-Antagonists/therapeutic use
• Amiodarone/therapeutic use
• Anti-Arrhythmia Agents/therapeutic use
• Atrial Fibrillation/etiology
• Atrial Fibrillation/prevention & control
• Atrial Fibrillation/therapy
• Evidence-Based Medicine
• Humans
• Magnesium/therapeutic use
• Postoperative Care/methods
• Sotalol/therapeutic use
• Thoracic Surgical Procedures/adverse effects

• Aged
• Aged, 80 and over
• Anti-Arrhythmia Agents/therapeutic use
• Atrial Fibrillation/drug therapy
• Atrial Fibrillation/etiology
• Atrial Fibrillation/therapy
• Cardiac Pacing, Artificial
• Cardiac Surgical Procedures/adverse effects
• Defibrillators, Implantable
• Electric Countershock/instrumentation
• Equipment Design
• Female
• Hospital Mortality
• Humans
• Male
• Prospective Studies
• Treatment Outcome

• Bundle-Branch Block/diagnosis
• Bundle-Branch Block/etiology
• Bundle-Branch Block/mortality
• Bundle-Branch Block/physiopathology
• Bundle-Branch Block/therapy
• Clinical Trials as Topic
• Coronary Artery Bypass/adverse effects
• Heart Conduction System/physiopathology
• Humans
• Meta-Analysis as Topic
• Survival Analysis
• Time Factors

• Aged
• Algorithms
• Atrial Fibrillation/epidemiology
• Atrial Fibrillation/etiology
• Coronary Artery Bypass/adverse effects
• Decision Trees
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Risk Assessment
• Risk Factors
• Statistics, Nonparametric
• Stroke Volume

• Aged
• Coronary Angiography
• Coronary Artery Bypass, Off-Pump/methods
• Coronary Vasospasm/diagnostic imaging
• Coronary Vasospasm/etiology
• Creatine Kinase/blood
• Creatine Kinase, MB Form/blood
• Humans
• Male

• Cardiac Surgical Procedures
• Critical Care
• Heart Arrest/therapy
• Heart Rate
• Hemodynamics
• Humans
• Intraoperative Care
• Monitoring, Physiologic/methods
• Myocardial Contraction
• Postoperative Care
• Postoperative Hemorrhage/therapy
• Time Factors

• Adult
• Aged
• Aged, 80 and over
• Arrhythmias, Cardiac/classification
• Arrhythmias, Cardiac/etiology
• Coronary Artery Bypass
• Electrocardiography
• Female
• Humans
• Logistic Models
• Male
• Medical Records Systems, Computerized
• Middle Aged
• Postoperative Complications/epidemiology
• Postoperative Complications/physiopathology

• Aged
• Cardiac Surgical Procedures/adverse effects
• Coronary Artery Bypass/adverse effects
• Female
• Heart Valves/surgery
• Humans
• Male
• Middle Aged
• Postoperative Complications
• Prospective Studies
• Risk Factors
• Tachycardia, Ventricular/diagnosis
• Tachycardia, Ventricular/etiology
• Tachycardia, Ventricular/therapy
• Ventricular Fibrillation/diagnosis
• Ventricular Fibrillation/etiology
• Ventricular Fibrillation/therapy

• Adult
• Aged
• Anesthesia, General
• Cardiac Surgical Procedures
• Cardiopulmonary Bypass
• Critical Care
• Evidence-Based Medicine
• Humans
• Middle Aged
• Monitoring, Physiologic
• Postoperative Care
• Postoperative Complications/therapy
• Preoperative Care
• Risk Assessment
• Thoracic Surgery

• Aged
• Angina, Unstable/complications
• Angina, Unstable/epidemiology
• Angina, Unstable/surgery
• Anti-Arrhythmia Agents
• Atrial Fibrillation/drug therapy
• Atrial Fibrillation/epidemiology
• Atrial Fibrillation/etiology
• Cardiac Catheterization
• Coronary Angiography
• Coronary Artery Bypass/adverse effects
• Coronary Artery Bypass/methods
• Electrocardiography
• Female
• Heart-Assist Devices/adverse effects
• Humans
• Incidence
• Male
• Middle Aged
• Postoperative Care
• Postoperative Complications
• Risk Factors
• Treatment Outcome

• Cardioplegic Solutions/pharmacology
• Coronary Artery Bypass
• Female
• Heart Arrest, Induced
• Heart Conduction System/drug effects
• Humans
• Male
• Middle Aged
• Prospective Studies
• Single-Blind Method

• Age Distribution
• Aged
• Atrial Fibrillation/epidemiology
• Atrial Fibrillation/prevention & control
• Coronary Angiography
• Coronary Artery Bypass/adverse effects
• Coronary Artery Bypass/methods
• Coronary Disease/diagnostic imaging
• Coronary Disease/surgery
• Female
• Follow-Up Studies
• Humans
• Incidence
• Ischemic Preconditioning, Myocardial/methods
• Logistic Models
• Male
• Middle Aged
• Postoperative Complications/epidemiology
• Postoperative Complications/prevention & control
• Postoperative Period
• Predictive Value of Tests
• Preoperative Care/methods
• Probability
• Reference Values
• Risk Assessment
• Sex Distribution
• Statistics, Nonparametric