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Atrial fibrillation and flutter after coronary artery bypass surgery: epidemiology, risk factors and preventive trials
Abstract
Atrial fibrillation and atrial flutter are common arrhythmias after coronary artery bypass grafting. Although the consequences of the arrhythmia are generally not life-threatening, it constitutes a major clinical problem often requiring conversion to sinus rhythm. Atrial fibrillation or flutter can result in hypotension, heart failure, pneumonia, and stroke. This article reviews the literature on epidemiology, electrophysiology, risk factors, and preventive trials. The major conclusions are: (1) In patients undergoing coronary artery bypass surgery, the incidence of postoperative atrial fibrillation or flutter is 20-30%, the peak incidence being on the second or third postoperative day. (2) The strongest independent preoperative predictor for atrial fibrillation or flutter is the patients' age. (3) Intra-atrial conduction delay recorded pre and peroperatively may predict development of atrial fibrillation. (4) Peroperative inducibility of atrial fibrillation by pacing the right atrium may identify patients at risk for postoperative atrial fibrillation. (5) Development of postoperative atrial fibrillation or flutter has not been associated with peroperative or postoperative events. (6) The specificity and sensitivity of age and other possible relevant factors for prediction of atrial fibrillation or flutter after coronary artery bypass grafting is low. (7) No effective prophylactic regimen has yet been established.
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“The incidence of atrial arrhythmias in the early postoperative period (days) after coronary artery by-pass surgery, is 20-30%.212”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [212]
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Metadata
- Authors
- Frost, L., Mølgaard, H., Christiansen, E. H., Hjortholm, K., Paulsen, P. K., & Thomsen, P. E. B.
- Affiliations
- Aarhus University Hospital (DK)
- Aarhus University (DK)
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1992-09
- Volume
- 36
- Issue
- 3
- Pages
- 253-261
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2065969709
- Cited by
- 136
- References
- 38
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 2 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 6 · 2015: 2 · 2014: 2 · 2013: 6 · 2012: 5
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Keywords
- atrial fibrillation, atrial flutter, coronary artery bypass grafting, postoperative arrhythmia, risk factors, right atrial pacing, age as predictor, prophylaxis, incidence, conversion to sinus rhythm
- MeSH terms
- Adrenergic beta-Antagonists, Age Factors, Coronary Artery Bypass, Atrial Fibrillation, Atrial Flutter, Cardiac Pacing, Artificial, Electrophysiology, Evaluation Studies as Topic, Humans, Postoperative Complications, Predictive Value of Tests, Risk Factors, Sensitivity and Specificity, Time Factors, Incidence
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