HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Xavier M. Mueller Hendrik T. Tevaearai Patrick Ruchat Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mueller, X. M. Articles by von Segesser, L. K. Search for Related Content PubMed PubMed Citation Articles by Mueller, X. M. Articles by von Segesser, L. K. Related Collections Electrophysiology - arrhythmias Minimally invasive surgery Related Article

J Thorac Cardiovasc Surg 2001;121:683-688
© 2001 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Did the introduction of a minimally invasive technique change the incidence of atrial fibrillation after single internal thoracic artery–left anterior descending artery grafting?

From the Clinic for Cardiovascular Surgery, CHUV (Centre Hospitalier Universitaire Vaudois), CH-1011 Lausanne, Switzerland.

Received for publication June 7, 2000. Revisions requested Aug 24, 2000; revisions received Sept 14, 2000. Accepted for publication Oct 27, 2000. Address for reprints: X. Mueller, MD, Clinic for Cardiovascular Surgery, CHUV (Centre Hospitalier Universitaire Vaudois), CH-1011 Lausanne, Switzerland (E-mail: xavier.mueller{at}chuv.hospvd.ch).

Abstract

Objective: Atrial fibrillation after coronary artery bypass operations remains frequent and increases morbidity, as well as resource use. Its cause remains unclear. The introduction of a minimally invasive technique provides an opportunity to evaluate the effect of intraoperative factors, such as cardiopulmonary bypass, global myocardial ischemia, and myocardial protection technique, on the occurrence of this arrhythmia.
Methods: All the patients undergoing isolated left internal thoracic artery–left anterior descending artery grafting between January 1994 and December 1999 were reviewed. Twenty possible risk factors for postoperative atrial fibrillation, including the choice of operative technique—minimally invasive technique was introduced in January 1997—were entered into univariate and multivariable logistic regression analysis.
Results: Postoperative atrial fibrillation occurred in 36 (20%) of 183 patients. On univariate analysis, age (P < .001) and a history of supraventricular arrhythmia (P < .001) were found to be risk factors. In particular, 15 (22%) of 69 patients operated on with the minimally invasive technique had postoperative atrial fibrillation versus 21 (18%) of 114 in the standard group (P = .58). On multivariable analysis, including the operative technique, the same variables (P = .001 and .01, respectively) were identified as independent risk factors.
Conclusions: The introduction of a minimally invasive technique for coronary artery bypass operations did not reduce the occurrence of postoperative atrial fibrillation in this study population. This suggests that prophylactic measures to reduce this arrhythmia should be focused on factors unrelated to cardiopulmonary bypass or myocardial preservation technique.

Related Article

Postoperative atrial fibrillation: An old problem crying for new solutions

Lawrence L. Creswell and Ralph J. Damiano, Jr
J. Thorac. Cardiovasc. Surg. 2001 121: 638-641. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				F. Bakhtiary, P. Therapidis, O. Dzemali, K. Ak, H. Ackermann, D. Meininger, P. Kessler, P. Kleine, A. Moritz, T. Aybek, et al. Impact of high thoracic epidural anesthesia on incidence of perioperative atrial fibrillation in off-pump coronary bypass grafting: A prospective randomized study J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 460 - 464. [Abstract] [Full Text] [PDF]

				G. Djaiani, B. Phillips-Bute, M. Podgoreanu, R. H. Messier, J. P. Mathew, F. Clements, and M. F. Newman The Association of Patent Foramen Ovale and Atrial Fibrillation After Coronary Artery Bypass Graft Surgery Anesth. Analg., March 1, 2004; 98(3): 585 - 589. [Abstract] [Full Text] [PDF]

				J. Melo, P. Voigt, B. Sonmez, M. Ferreira, M. Abecasis, M. Rebocho, A. Timoteo, C. Aguiar, S. Tansal, H. Arbatli, et al. Ventral cardiac denervation reduces the incidence of atrial fibrillation after coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 511 - 516. [Abstract] [Full Text] [PDF]

				Z.-K. Wu, T. Iivainen, E. Pehkonen, J. Laurikka, S. Zhang, and M. R. Tarkka Fibrillation in patients subjected to coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1477 - 1482. [Abstract] [Full Text] [PDF]

				L. L. Creswell and R. J. Damiano Jr Postoperative atrial fibrillation: An old problem crying for new solutions J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(90030): S20 - 23. [Full Text] [PDF]

				H. Shin, K. Hashizume, Y. Iino, K. Koizumi, T. Matayoshi, and R. Yozu Effects of atrial fibrillation on coronary artery bypass graft flow Eur. J. Cardiothorac. Surg., February 1, 2003; 23(2): 175 - 178. [Abstract] [Full Text] [PDF]

				L. L. Creswell and R. J. Damiano Jr Postoperative atrial fibrillation: An old problem crying for new solutions J. Thorac. Cardiovasc. Surg., April 1, 2001; 121(4): 638 - 641. [Full Text] [PDF]