Cited by 319Atrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmiasCardiac Arrhythmias and Treatments

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Inflammation of Atrium After Cardiac Surgery Is Associated With Inhomogeneity of Atrial Conduction and Atrial Fibrillation

Ishii, Yosuke, Schuessler, Richard B., Gaynor, Sydney L., Yamada, Kiyomi, Fu, Annabel S., Boineau, John P., Damiano, Ralph J.·2005·Circulation

DOI 10.1161/circulationaha.104.475194

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Abstract

BACKGROUND: Atrial fibrillation (AF) is common after cardiac surgery. Abnormal conduction is an important substrate for AF. We hypothesized that atrial inflammation alters atrial conduction properties. METHODS AND RESULTS: Normal mongrel canines (n=24) were divided into 4 groups consisting of anesthesia alone (control group); pericardiotomy (pericardiotomy group); lateral right atriotomy (atriotomy group); and lateral right atriotomy with antiinflammatory therapy (methylprednisolone 2 mg/kg per day) (antiinflammatory group). Right atrial activation was examined 3 days after surgery. Inhomogeneity of conduction was quantified by the variation of maximum local activation phase difference. To initiate AF, burst pacing was performed. Myeloperoxidase activity and neutrophil cell infiltration in the atrial myocardium were measured to quantify the degree of inflammation. The inhomogeneity of atrial conduction of the atriotomy and pericardiotomy groups was higher than that of the control group (2.02+/-0.10, 1.51+/-0.03 versus 0.96+/-0.08, respectively; P<0.005). Antiinflammatory therapy decreased the inhomogeneity of atrial conduction after atriotomy (1.16+/-0.10; P<0.001). AF duration was longer in the atriotomy and pericardiotomy groups than in the control and antiinflammatory groups (P=0.012). There also were significant differences in myeloperoxidase activity between the atriotomy and pericardiotomy groups and the control group (0.72+/-0.09, 0.41+/-0.08 versus 0.18+/-0.03 DeltaOD/min per milligram protein, respectively; P<0.001). Myeloperoxidase activity of the antiinflammatory group was lower than that of the atriotomy group (0.17+/-0.02; P<0.001). Inhomogeneity of conduction correlated with myeloperoxidase activity (r=0.851, P<0.001). CONCLUSIONS: The degree of atrial inflammation was associated with a proportional increase in the inhomogeneity of atrial conduction and AF duration. This may be a factor in the pathogenesis of early postoperative AF. Antiinflammatory therapy has the potential to decrease the incidence of AF after cardiac surgery.

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10.1161/circ.94.3.390 · DOI
10.1161/circ.96.10.3542 · DOI
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10.1161/circ.103.21.2631 · DOI
10.1161/circ.102.13.1530 · DOI

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Authors: Ishii, Y., Schuessler, R. B., Gaynor, S. L., Yamada, K., Fu, A. S., Boineau, J. P., & Damiano, R. J.
Affiliations: From the Divisions of Cardiothoracic Surgery (Y.I., R.B.S., S.L.G., A.S.F., J.P.B., R.J.D.) and Pathology (K.Y.), Washington University School of Medicine, St Louis, Mo.
Washington University in St. Louis (US)
ORCID: Damiano, Ralph J.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2005-06-07
Volume: 111
Issue: 22
Pages: 2881-2888
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.104.475194
OpenAlex: W1994401913
Cited by: 319
References: 28
Citations by year: 2026: 15 · 2025: 17 · 2024: 12 · 2023: 19 · 2022: 18 · 2021: 20 · 2020: 18 · 2019: 11 · 2018: 11 · 2017: 13 · 2016: 23 · 2015: 16 · 2014: 15 · 2013: 12 · 2012: 28
FWCI: 5.67
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Heart, Lung, and Blood Institute (R01HL032257)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Keywords: atrial fibrillation, atrial inflammation, postoperative atrial arrhythmia, cardiac surgery, pericardiotomy, right atriotomy, methylprednisolone, anti-inflammatory therapy, myeloperoxidase, neutrophil infiltration, canine model, atrial substrate, burst pacing, atrial activation
MeSH terms: Animals, Anti-Inflammatory Agents, Atrial Fibrillation, Dogs, Electrophysiology, Heart Atria, Heart Conduction System, Cardiac Surgical Procedures, Inflammation, Peroxidase, Postoperative Complications, Time Factors

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Inflammation of Atrium After Cardiac Surgery Is Associated With Inhomogeneity of Atrial Conduction and Atrial Fibrillation

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