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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | WU, Dehua LI, Qiongzhen XU, Meiying WU, Jingxiang Yang, Jun |
| Abstract | Objective Prophylactic pharmacological conversion agents could reduce the incidence of postoperative atrial fibrillation (AF) in patients undergoing thoracic operations. The current study examined whether the use of pharmacological conversion agents could help to restore sinus rhythm in patients with AF newly developed during thoracic operations. Methods Medical records of 18,605 patients from January 1, 2015 to December 31, 2019, at the Shanghai Chest Hospital were reviewed. Patients with non-sinus rhythm prior to the surgery (n = 128) were excluded from data analysis. The final analysis included 18,477 patients (n = 16,292 undergoing lung operations; n = 2,185 undergoing esophageal operations). Results Intraoperative AF (defined as AF lasting for at least 5 min) occurred in 646 out of a total of 18,477 subjects (3.49%). Within the 646 subjects, 258 received pharmacological conversion agents during the surgery. sinus rhythm was restored in 20.15% (52/248) of patients treated with pharmacological cardioversion and in 20.87% (81/399) patients not receiving pharmacological intervention. In a subgroup analysis of the 258 patients receiving pharmacological conversion agents, recovery of sinus rhythm was highest in beta-blocker group (35.59%, 21/59 vs. 15.78%, 15/95 in amiodarone group, p = 0.008, 5.55%, and 1/18 in amiodarone plus beta-blockers group, p = 0.016). The incidence of hypotension was higher in pharmacological conversion (27.5% vs. 9.3% in patients not receiving pharmacological intervention, p < 0.001). In subjects not recovering to sinus rhythm during the surgery (n = 513), electrical cardioversion in post-anesthesia care unit (PACU) restored sinus rhythm in > 98% of the cases (155/158 vs. 63/355 in subjects not receiving cardioversion; p < 0.001). Conclusions Our experience shows that pharmacological conversion, in general, failed to show better treatment effectiveness on intraoperative new-onset AF within period of surgery except for beta-blockers. Patients with AF persisting beyond the surgery could be effectively managed with electrical cardioversion. |
| Related Links | https://cardiothoracicsurgery.biomedcentral.com/counter/pdf/10.1186/s13019-023-02236-y.pdf |
| Ending Page | 8 |
| Page Count | 8 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 17498090 |
| DOI | 10.1186/s13019-023-02236-y |
| Journal | Journal of Cardiothoracic Surgery |
| Issue Number | 1 |
| Volume Number | 18 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-04-07 |
| Access Restriction | Open |
| Subject Keyword | Cardiac Surgery Thoracic Surgery Atrial fibrillation Pharmacological conversion Electrical cardioversion |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine |
| Journal Impact Factor | 1.5/2023 |
| 5-Year Journal Impact Factor | 1.6/2023 |
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