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Titolo:
Effectiveness of bi-atrial pacing for reducing atrial fibrillation after coronary artery bypass graft surgery
Autore:
Gerstenfeld, EP; Khoo, M; Martin, RC; Cook, JR; Lancey, R; Rofino, K; Vander Salm, TJ; Mittleman, RS;
Indirizzi:
Univ Massachusetts, Med Ctr, Dept Med, Worcester, MA USA Univ Massachusetts Worcester MA USA Med Ctr, Dept Med, Worcester, MA USA Univ Massachusetts, Med Ctr, Dept Cardiothorac Surg, Worcester, MA USA Univ Massachusetts Worcester MA USA Cardiothorac Surg, Worcester, MA USA Baystate Med Ctr, Dept Med, Springfield, MA 01199 USA Baystate Med Ctr Springfield MA USA 01199 Med, Springfield, MA 01199 USA
Titolo Testata:
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
fascicolo: 3, volume: 5, anno: 2001,
pagine: 275 - 283
SICI:
1383-875X(2001)5:3<275:EOBPFR>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEART-SURGERY; DOUBLE-BLIND; PREVENTION; METAANALYSIS; PREDICTORS; SITE;
Keywords:
atrial fibrillation; coronary artery bypass graft surgery; bi-atrial pacing;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Gerstenfeld, EP Hosp Univ Penn, 9 Founders,3400 Spruce St, Philadelphia, PA 19103 USA Hosp Univ Penn 9 Founders,3400 Spruce St Philadelphia PA USA 19103
Citazione:
E.P. Gerstenfeld et al., "Effectiveness of bi-atrial pacing for reducing atrial fibrillation after coronary artery bypass graft surgery", J INTERV C, 5(3), 2001, pp. 275-283

Abstract

Atrial fibrillation (AF) is common after cardiac surgery and adds significant cost and morbidity. The use of prophylactic pacing strategies to prevent post-operative AF has been controversial. We previously performed a pilotstudy which suggested that the combination of beta-blockers and bi-atrial pacing (BAP) may reduce AF after cardiac surgery. We prospectively randomized 118 patients to continuous BAP for up to 96 hours post-operatively versus standard therapy. All patients were treated with beta-blockers as tolerated. Patients were paced in the AAI mode at a rateof 100 pulses per minute. The primary endpoint of the study was the occurrence of sustained AF (> 10 minutes). There was a significant reduction in the incidence of AF in the BAP group among patients undergoing coronary artery bypass graft surgery with or without aortic valve replacement (35 % vs. 19 % AF; OR=0.38, 95 % CI 0.15, 0.93; p <0.05). Including patients undergoing isolated aortic valve surgery (n=7), there remained a strong trend toward a reduction of AF with pacing (no atrial pacing [NAP] vs. BAP; 35 % vs. 21 % AF; OR=0.48, 95 % CI 0.21, 1.11;p=0.08). Patients age 70 or greater benefited most from pacing (NAP vs. BAP; 55 vs. 25 % AF; p <0.05), while those less than 70 years of age did not (17 vs. 18 % p=NS). There was a significant reduction in the amount of timespent in the intensive care unit among patients receiving BAP (50 +/- 40 vs. 37 +/- 25[emsp4 ]h; p <0.05). BAP together with beta-blockade after coronary artery bypass graft surgeryreduces the incidence of post-operative atrial AF. Elderly patients (age 70 or greater) appear to benefit most, and may be a group to whom this therapy should be targeted.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 20:37:11