Skip to main content
SpringerLink
Log in

Postoperative Atrial Fibrillation Following Cardiac Surgery: From Pathogenesis to Potential Therapies

  • Review Article
  • Published:
American Journal of Cardiovascular Drugs Aims and scope Submit manuscript

Abstract

Postoperative atrial fibrillation (POAF) is a major complication after cardiac surgery which can lead to high rates of morbidity and mortality, an enhanced length of hospital stay, and an increased cost of care. POAF is postulated to be a multifactorial phenomenon; however, some major pathogeneses have been proposed, including inflammatory pathways, oxidative stress, and autonomic dysfunction. Genetic studies also showed that inflammatory pathways, beta-1 adrenoreceptor variants, G protein-coupled receptor kinase 5 gene variants, and non-coding single-nucleotide polymorphisms in the 4q25 chromosomal locus are involved in this phenomenon. Moreover, several predisposing factors lead to the development of POAF, consisting of pre-, intra-, and postoperative contributors. The main predisposing factors comprise age, prior history of major cardiovascular risk factors, and ischemia-reperfusion injury during surgery. The management of POAF is based on the usual therapies used for non-surgical AF, including medications for either rate control or rhythm control in hemodynamically unstable patients. The perioperative administration of β-blockers and some antiarrhythmic agents has been recommended in major international guidelines. In addition, upstream therapies consisting of colchicine, magnesium, statins, and antioxidants have attenuated the incidence of POAF; however, some uncomfortable side effects developed in large randomized trials. The use of anticoagulation has also resulted in less mortality in patients with POAF at higher risk of thromboembolic events. Despite these recommendations, the actual regimen for the prevention of POAF remains controversial. In this review, we highlight the pathogenesis, predisposing factors, and potential therapeutic options for the management of patients at risk for or with POAF following cardiac surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Aranki SF, Shaw DP, Adams DH, Rizzo RJ, Couper GS, VanderVliet M, et al. Predictors of atrial fibrillation after coronary artery surgery. Current trends and impact on hospital resources. Circulation. 1996;94:390–7.

    Article  CAS  PubMed  Google Scholar 

  2. Raiten J, Patel PA, Gutsche J, Management of postoperative atrial fibrillation in cardiac surgery patients. 2015. In: Conference management of postoperative atrial fibrillation in cardiac surgery patients, pp. 122–29. SAGE Publications

  3. Yadava M, Hughey AB, Crawford TC. Postoperative atrial fibrillation: incidence, mechanisms, and clinical correlates. Cardiol Clin. 2014;32:627–36.

    Article  PubMed  Google Scholar 

  4. Ferro CR, Oliveira DC, Nunes FP, Piegas LS. Postoperative atrial fibrillation after cardiac surgery. Arq Bras Cardiol. 2009;93:59–63.

    Article  PubMed  Google Scholar 

  5. Echahidi N, Pibarot P, O’Hara G, Mathieu P. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery. J Am Coll Cardiol. 2008;51:793–801.

    Article  CAS  PubMed  Google Scholar 

  6. Mathew JP, Fontes ML, Tudor IC, Ramsay J, Duke P, Mazer CD, et al. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA. 2004;291:1720–9.

    Article  CAS  PubMed  Google Scholar 

  7. Lee JK, Klein GJ, Krahn AD, Yee R, Zarnke K, Simpson C, et al. Rate-control versus conversion strategy in postoperative atrial fibrillation: a prospective, randomized pilot study. Am Heart J. 2000;140:871–7.

    Article  CAS  PubMed  Google Scholar 

  8. Frendl G, Sodickson AC, Chung MK, Waldo AL, Gersh BJ, Tisdale JE, et al. 2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures. J Thoracic Cardiovasc Surg. 2014;148:e153–93.

    Article  Google Scholar 

  9. Maesen B, Nijs J, Maessen J, Allessie M, Schotten U. Post-operative atrial fibrillation: a maze of mechanisms. Europace. 2012;14:159–74.

    Article  PubMed  Google Scholar 

  10. Maisel WH, Rawn JD, Stevenson WG. Atrial fibrillation after cardiac surgery. Ann Intern Med. 2001;135:1061–73.

    Article  CAS  PubMed  Google Scholar 

  11. Auer J, Weber T, Berent R, Ng CK, Lamm G, Eber B. Risk factors of postoperative atrial fibrillation after cardiac surgery. J Card Surg. 2005;20:425–31.

    Article  PubMed  Google Scholar 

  12. Zangrillo A, Landoni G, Sparicio D, Benussi S, Aletti G, Pappalardo F, et al. Predictors of atrial fibrillation after off-pump coronary artery bypass graft surgery. J Cardiothorac Vasc Anesthesia. 2004;18:704–8.

    Article  Google Scholar 

  13. Andrews TC, Reimold SC, Berlin JA, Antman EM. Prevention of supraventricular arrhythmias after coronary artery bypass surgery. A meta-analysis of randomized control trials. Circulation. 1991;84:Iii236–44.

    CAS  PubMed  Google Scholar 

  14. Fuller JA, Adams GG, Buxton B. Atrial fibrillation after coronary artery bypass grafting. Is it a disorder of the elderly? J Thorac Cardiovasc Surg. 1989;97:821–5.

    Article  CAS  PubMed  Google Scholar 

  15. Leitch JW, Thomson D, Baird DK, Harris PJ. The importance of age as a predictor of atrial fibrillation and flutter after coronary artery bypass grafting. J Thorac Cardiovasc Surg. 1990;100:338–42.

    Article  CAS  PubMed  Google Scholar 

  16. Mathew JP, Parks R, Savino JS, Friedman AS, Koch C, Mangano DT, et al. Atrial fibrillation following coronary artery bypass graft surgery: predictors, outcomes, and resource utilization. MultiCenter Study of Perioperative Ischemia Research Group. JAMA. 1996;276:300–6.

    Article  CAS  PubMed  Google Scholar 

  17. Li D, Fareh S, Leung TK, Nattel S. Promotion of atrial fibrillation by heart failure in dogs: atrial remodeling of a different sort. Circulation. 1999;100:87–95.

    Article  CAS  PubMed  Google Scholar 

  18. Echahidi N, Mohty D, Pibarot P, Despres JP, O’Hara G, Champagne J, et al. Obesity and metabolic syndrome are independent risk factors for atrial fibrillation after coronary artery bypass graft surgery. Circulation. 2007;116:I213–9.

    Article  PubMed  Google Scholar 

  19. Ishii Y, Schuessler RB, Gaynor SL, Yamada K, Fu AS, Boineau JP, et al. Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial conduction and atrial fibrillation. Circulation. 2005;111:2881–8.

    Article  CAS  PubMed  Google Scholar 

  20. Rezaei Y. Anti-inflammatory role of statins in preventing postoperative atrial fibrillation. Am J Cardiol. 2016;117:314.

    Article  CAS  PubMed  Google Scholar 

  21. Tselentakis EV, Woodford E, Chandy J, Gaudette GR, Saltman AE. Inflammation effects on the electrical properties of atrial tissue and inducibility of postoperative atrial fibrillation. J Surg Res. 2006;135:68–75.

    Article  CAS  PubMed  Google Scholar 

  22. Abdelhadi RH, Gurm HS, Van Wagoner DR, Chung MK. Relation of an exaggerated rise in white blood cells after coronary bypass or cardiac valve surgery to development of atrial fibrillation postoperatively. Am J Cardiol. 2004;93:1176–8.

    Article  PubMed  Google Scholar 

  23. Dehghani MR, Kasianzadeh M, Rezaei Y, Sepehrvand N. Atorvastatin reduces the incidence of postoperative atrial fibrillation in statin-naive patients undergoing isolated heart valve surgery: a double-blind, placebo-controlled randomized trial. J Cardiovasc Pharmacol Therapeutics. 2015;20:465–72.

    Article  CAS  Google Scholar 

  24. Elahi MM, Flatman S, Matata BM. Tracing the origins of postoperative atrial fibrillation: the concept of oxidative stress-mediated myocardial injury phenomenon. Eur J Cardiovasc Prev Rehabil. 2008;15:735–41.

    Article  PubMed  Google Scholar 

  25. Siebert J, Lewicki L, Mlodnicki M, Rogowski J, Lango R, Anisimowicz L et al. Atrial fibrillation after conventional and off-pump coronary artery bypass grafting: two opposite trends in timing of atrial fibrillation occurrence? Med Sci Monit 2003;9:Cr137–41.

  26. Turk T, Vural H, Eris C, Ata Y, Yavuz S. Atrial fibrillation after off-pump coronary artery surgery: a prospective, matched study. J Int Med Res. 2007;35:134–42.

    Article  CAS  PubMed  Google Scholar 

  27. Ucar HI, Tok M, Atalar E, Dogan OF, Oc M, Farsak B, et al. Predictive significance of plasma levels of interleukin-6 and high-sensitivity C-reactive protein in atrial fibrillation after coronary artery bypass surgery. Heart Surg Forum. 2007;10:E131–5.

    Article  PubMed  Google Scholar 

  28. Enc Y, Ketenci B, Ozsoy D, Camur G, Kayacioglu I, Terzi S, et al. Atrial fibrillation after surgical revascularization: is there any difference between on-pump and off-pump? Eur J Cardio-thoracic Surg. 2004;26:1129–33.

    Article  Google Scholar 

  29. Zamvar V, Williams D, Hall J, Payne N, Cann C, Young K, et al. Assessment of neurocognitive impairment after off-pump and on-pump techniques for coronary artery bypass graft surgery: prospective randomised controlled trial. BMJ (Clin Res ed). 2002;325:1268.

    Article  Google Scholar 

  30. Legare JF, Buth KJ, King S, Wood J, Sullivan JA, Hancock Friesen C, et al. Coronary bypass surgery performed off pump does not result in lower in-hospital morbidity than coronary artery bypass grafting performed on pump. Circulation. 2004;109:887–92.

    Article  PubMed  Google Scholar 

  31. Ishida K, Kimura F, Imamaki M, Ishida A, Shimura H, Kohno H, et al. Relation of inflammatory cytokines to atrial fibrillation after off-pump coronary artery bypass grafting. Eur J Cardio-thoracic Surg. 2006;29:501–5.

    Article  Google Scholar 

  32. Lo B, Fijnheer R, Nierich AP, Bruins P, Kalkman CJ. C-reactive protein is a risk indicator for atrial fibrillation after myocardial revascularization. Ann Thorac Surg. 2005;79:1530–5.

    Article  PubMed  Google Scholar 

  33. Patti G, Chello M, Candura D, Pasceri V, D’Ambrosio A, Covino E, et al. Randomized trial of atorvastatin for reduction of postoperative atrial fibrillation in patients undergoing cardiac surgery: results of the ARMYDA-3 (Atorvastatin for Reduction of MYocardial Dysrhythmia After cardiac surgery) study. Circulation. 2006;114:1455–61.

    Article  CAS  PubMed  Google Scholar 

  34. Rezaei Y, Gholami-Fesharaki M, Dehghani MR, Arya A, Haghjoo M, Arjmand N. Statin antiarrhythmic effect on atrial fibrillation in statin-naive patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials. J Cardiovasc Pharmacol Therapeut. 2016;21:167–76.

    Article  CAS  Google Scholar 

  35. Gulick T, Chung MK, Pieper SJ, Lange LG, Schreiner GF. Interleukin 1 and tumor necrosis factor inhibit cardiac myocyte beta-adrenergic responsiveness. Proc Natl Acad Sci USA. 1989;86:6753–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Yokoyama T, Vaca L, Rossen RD, Durante W, Hazarika P, Mann DL. Cellular basis for the negative inotropic effects of tumor necrosis factor-alpha in the adult mammalian heart. J Clin Invest. 1993;92:2303–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Pagani FD, Baker LS, Hsi C, Knox M, Fink MP, Visner MS. Left ventricular systolic and diastolic dysfunction after infusion of tumor necrosis factor-alpha in conscious dogs. J Clin Invest. 1992;90:389–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Wan S, Yim AP. Cytokines in myocardial injury: impact on cardiac surgical approach. Eur J Cardio-thorac Surg. 1999;16(Suppl 1):S107–11.

    Article  Google Scholar 

  39. Chandrasekar B, Mitchell DH, Colston JT, Freeman GL. Regulation of CCAAT/enhancer binding protein, interleukin-6, interleukin-6 receptor, and gp130 expression during myocardial ischemia/reperfusion. Circulation. 1999;99:427–33.

    Article  CAS  PubMed  Google Scholar 

  40. Wu ZK, Laurikka J, Vikman S, Nieminen R, Moilanen E, Tarkka MR. High postoperative interleukin-8 levels related to atrial fibrillation in patients undergoing coronary artery bypass surgery. World J Surg. 2008;32:2643–9.

    Article  PubMed  Google Scholar 

  41. McCord JM. Oxygen-derived free radicals in postischemic tissue injury. N Engl J Med. 1985;312:159–63.

    Article  CAS  PubMed  Google Scholar 

  42. Suleiman MS, Halestrap AP, Griffiths EJ. Mitochondria: a target for myocardial protection. Pharmacol Ther. 2001;89:29–46.

    Article  CAS  PubMed  Google Scholar 

  43. Suleiman MS, Zacharowski K, Angelini GD. Inflammatory response and cardioprotection during open-heart surgery: the importance of anaesthetics. Br J Pharmacol. 2008;153:21–33.

    Article  CAS  PubMed  Google Scholar 

  44. Grossmann M, Nakamura Y, Grumont R, Gerondakis S. New insights into the roles of ReL/NF-kappa B transcription factors in immune function, hemopoiesis and human disease. Int J Biochem Cell Biol. 1999;31:1209–19.

    Article  CAS  PubMed  Google Scholar 

  45. Anedda A, Lopez-Bernardo E, Acosta-Iborra B, Saadeh Suleiman M, Landazuri MO, Cadenas S. The transcription factor Nrf2 promotes survival by enhancing the expression of uncoupling protein 3 under conditions of oxidative stress. Free Radical Biol Med. 2013;61:395–407.

    Article  CAS  Google Scholar 

  46. Grossini E, Molinari C, Caimmi PP, Uberti F, Vacca G. Levosimendan induces NO production through p38 MAPK, ERK and Akt in porcine coronary endothelial cells: role for mitochondrial K(ATP) channel. Br J Pharmacol. 2009;156:250–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Jeong EM, Liu M, Sturdy M, Gao G, Varghese ST, Sovari AA, et al. Metabolic stress, reactive oxygen species, and arrhythmia. J Mol Cell Cardiol. 2012;52:454–63.

    Article  CAS  PubMed  Google Scholar 

  48. Kim YM, Guzik TJ, Zhang YH, Zhang MH, Kattach H, Ratnatunga C, et al. A myocardial Nox2 containing NAD(P)H oxidase contributes to oxidative stress in human atrial fibrillation. Circ Res. 2005;97:629–36.

    Article  CAS  PubMed  Google Scholar 

  49. Relevy H, Koshkaryev A, Manny N, Yedgar S, Barshtein G. Blood banking-induced alteration of red blood cell flow properties. Transfusion. 2008;48:136–46.

    PubMed  Google Scholar 

  50. Giustarini D, Dalle-Donne I, Tsikas D, Rossi R. Oxidative stress and human diseases: origin, link, measurement, mechanisms, and biomarkers. Crit Rev Clin Lab Sci. 2009;46:241–81.

    Article  CAS  PubMed  Google Scholar 

  51. Lenaerts I, Driesen RB, Hermida N, Holemans P, Heidbuchel H, Janssens S et al. Role of nitric oxide and oxidative stress in a sheep model of persistent atrial fibrillation. Europace 2013;15:754–60.

    Article  Google Scholar 

  52. Nishijima Y, Sridhar A, Bonilla I, Velayutham M, Khan M, Terentyeva R, et al. Tetrahydrobiopterin depletion and NOS2 uncoupling contribute to heart failure-induced alterations in atrial electrophysiology. Cardiovasc Res. 2011;91:71–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Clermont G, Vergely C, Jazayeri S, Lahet JJ, Goudeau JJ, Lecour S, et al. Systemic free radical activation is a major event involved in myocardial oxidative stress related to cardiopulmonary bypass. Anesthesiology. 2002;96:80–7.

    Article  CAS  PubMed  Google Scholar 

  54. Ramlawi B, Otu H, Mieno S, Boodhwani M, Sodha NR, Clements RT et al. Oxidative stress and atrial fibrillation after cardiac surgery: a case–control study. Ann Thorac Surg 2007;84:1166–72; (discussion 72–3).

    Article  PubMed  Google Scholar 

  55. Wu JH, Marchioli R, Silletta MG, Masson S, Sellke FW, Libby P et al. Oxidative Stress Biomarkers and Incidence of Postoperative Atrial Fibrillation in the Omega-3 Fatty Acids for Prevention of Postoperative Atrial Fibrillation (OPERA) Trial. J Am Heart Assoc 2015;4.

  56. Eslami M, Badkoubeh RS, Mousavi M, Radmehr H, Salehi M, Tavakoli N, et al. Oral ascorbic acid in combination with beta-blockers is more effective than beta-blockers alone in the prevention of atrial fibrillation after coronary artery bypass grafting. Tex Heart Inst J. 2007;34:268–74.

    PubMed  PubMed Central  Google Scholar 

  57. Ozaydin M, Peker O, Erdogan D, Kapan S, Turker Y, Varol E, et al. N-acetylcysteine for the prevention of postoperative atrial fibrillation: a prospective, randomized, placebo-controlled pilot study. Eur Heart J. 2008;29:625–31.

    Article  CAS  PubMed  Google Scholar 

  58. Workman AJ. Cardiac adrenergic control and atrial fibrillation. Naunyn-Schmiedeberg Arch Pharmacol. 2010;381:235–49.

    Article  CAS  Google Scholar 

  59. Waldo AL. Mechanisms of atrial fibrillation, atrial flutter, and ectopic atrial tachycardia–a brief review. Circulation 1987;75:Iii37–40.

  60. Kalman JM, Munawar M, Howes LG, Louis WJ, Buxton BF, Gutteridge G, et al. Atrial fibrillation after coronary artery bypass grafting is associated with sympathetic activation. Ann Thorac Surg. 1995;60:1709–15.

    Article  CAS  PubMed  Google Scholar 

  61. Almassi GH, Schowalter T, Nicolosi AC, Aggarwal A, Moritz TE, Henderson WG, et al. Atrial fibrillation after cardiac surgery: a major morbid event? Ann Surg. 1997;226:501.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Melo J, Voigt P, Sonmez B, Ferreira M, Abecasis M, Rebocho M, et al. Ventral cardiac denervation reduces the incidence of atrial fibrillation after coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2004;127:511–6.

    Article  PubMed  Google Scholar 

  63. Omran AS, Karimi A, Ahmadi H, Yazdanifard P, Sheikh Fahtollahi M, Tazik M. Prophylactic ventral cardiac denervation: does it reduce incidence of atrial fibrillation after coronary artery bypass grafting? J Thorac Cardiovasc Surg. 2010;140:1036–9.

    Article  PubMed  Google Scholar 

  64. Alex J, Guvendik L. Evaluation of ventral cardiac denervation as a prophylaxis against atrial fibrillation after coronary artery bypass grafting. Ann Thorac Surg. 2005;79:517–20.

    Article  PubMed  Google Scholar 

  65. Fleming GA, Murray KT, Yu C, Byrne JG, Greelish JP, Petracek MR, et al. Milrinone use is associated with postoperative atrial fibrillation after cardiac surgery. Circulation. 2008;118:1619–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Feneck RO, Sherry KM, Withington PS, Oduro-Dominah A. Comparison of the hemodynamic effects of milrinone with dobutamine in patients after cardiac surgery. J Cardiothorac Vasc Anesth. 2001;15:306–15.

    Article  CAS  PubMed  Google Scholar 

  67. Haghjoo M, Saravi M, Hashemi MJ, Hosseini S, Givtaj N, Ghafarinejad MH, et al. Optimal beta-blocker for prevention of atrial fibrillation after on-pump coronary artery bypass graft surgery: carvedilol versus metoprolol. Heart Rhythm. 2007;4:1170–4.

    Article  PubMed  Google Scholar 

  68. Levy MN. Sympathetic-parasympathetic interactions in the heart. Circ Res. 1971;29:437–45.

    Article  CAS  PubMed  Google Scholar 

  69. Burashnikov A, Antzelevitch C. Reinduction of atrial fibrillation immediately after termination of the arrhythmia is mediated by late phase 3 early afterdepolarization-induced triggered activity. Circulation. 2003;107:2355–60.

    Article  PubMed  Google Scholar 

  70. Hogue CW Jr, Domitrovich PP, Stein PK, Despotis GD, Re L, Schuessler RB, et al. RR interval dynamics before atrial fibrillation in patients after coronary artery bypass graft surgery. Circulation. 1998;98:429–34.

    Article  PubMed  Google Scholar 

  71. Dimmer C, Tavernier R, Gjorgov N, Van Nooten G, Clement DL, Jordaens L. Variations of autonomic tone preceding onset of atrial fibrillation after coronary artery bypass grafting. Am J Cardiol. 1998;82:22–5.

    Article  CAS  PubMed  Google Scholar 

  72. Van Wagoner DR, Pond AL, Lamorgese M, Rossie SS, McCarthy PM, Nerbonne JM. Atrial L-type Ca2+ currents and human atrial fibrillation. Circ Res. 1999;85:428–36.

    Article  PubMed  Google Scholar 

  73. Yang R, Ernst P, Song J, Liu XM, Huke S, Wang S, et al. Mitochondrial-mediated oxidative Ca(2+)/calmodulin-dependent kinase II activation induces early afterdepolarizations in guinea pig cardiomyocytes: an in silico study. J Am Heart Assoc. 2018;7:e008939.

    CAS  PubMed  PubMed Central  Google Scholar 

  74. Workman AJ, Pau D, Redpath CJ, Marshall GE, Russell JA, Kane KA, et al. Post-operative atrial fibrillation is influenced by beta-blocker therapy but not by pre-operative atrial cellular electrophysiology. J Cardiovasc Electrophysiol. 2006;17:1230–8.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Swartz MF, Fink GW, Lutz CJ, Taffet SM, Berenfeld O, Vikstrom KL, et al. Left versus right atrial difference in dominant frequency, K(+) channel transcripts, and fibrosis in patients developing atrial fibrillation after cardiac surgery. Heart Rhythm. 2009;6:1415–22.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Brandt MC, Priebe L, Bohle T, Sudkamp M, Beuckelmann DJ. The ultrarapid and the transient outward K(+) current in human atrial fibrillation. Their possible role in postoperative atrial fibrillation. J Mol Cell Cardiol 2000;32:1885-96.

    Article  CAS  PubMed  Google Scholar 

  77. Laurent G, Leong-Poi H, Mangat I, Moe GW, Hu X, So PP, et al. Effects of chronic gap junction conduction-enhancing antiarrhythmic peptide GAP-134 administration on experimental atrial fibrillation in dogs. Circ Arrhythm Electrophysiol. 2009;2:171–8.

    Article  CAS  PubMed  Google Scholar 

  78. Dupont E, Ko Y, Rothery S, Coppen SR, Baghai M, Haw M, et al. The gap-junctional protein connexin40 is elevated in patients susceptible to postoperative atrial fibrillation. Circulation. 2001;103:842–9.

    Article  CAS  PubMed  Google Scholar 

  79. Ad N, Schneider A, Khaliulin I, Borman JB, Schwalb H. Impaired mitochondrial response to simulated ischemic injury as a predictor of the development of atrial fibrillation after cardiac surgery: In vitro study in human myocardium. J Thorac Cardiovasc Surg. 2005;129:41–5.

    Article  PubMed  Google Scholar 

  80. Sandler N, Kaczmarek E, Itagaki K, Zheng Y, Otterbein L, Khabbaz K, et al. Mitochondrial DAMPs are released during cardiopulmonary bypass surgery and are associated with postoperative atrial fibrillation. Heart Lung Circ. 2018;27:122–9.

    Article  PubMed  Google Scholar 

  81. Galea R, Cardillo MT, Caroli A, Marini MG, Sonnino C, Narducci ML, et al. Inflammation and C-reactive protein in atrial fibrillation: cause or effect? Tex Heart Inst J. 2014;41:461–8.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Goette A, Juenemann G, Peters B, Klein HU, Roessner A, Huth C, et al. Determinants and consequences of atrial fibrosis in patients undergoing open heart surgery. Cardiovasc Res. 2002;54:390–6.

    Article  CAS  PubMed  Google Scholar 

  83. Spach MS, Dolber PC. Relating extracellular potentials and their derivatives to anisotropic propagation at a microscopic level in human cardiac muscle. Evidence for electrical uncoupling of side-to-side fiber connections with increasing age. Circ Res 1986;58:356–71.

    Article  CAS  PubMed  Google Scholar 

  84. Ad N, Snir E, Vidne BA, Golomb E. Histologic atrial myolysis is associated with atrial fibrillation after cardiac operation. Ann Thorac Surg. 2001;72:688–93.

    Article  CAS  PubMed  Google Scholar 

  85. Ak K, Akgun S, Tecimer T, Isbir CS, Civelek A, Tekeli A, et al. Determination of histopathologic risk factors for postoperative atrial fibrillation in cardiac surgery. Ann Thorac Surg. 2005;79:1970–5.

    Article  PubMed  Google Scholar 

  86. Fu XX, Zhao N, Dong Q, Du LL, Chen XJ, Wu QF, et al. Interleukin-17A contributes to the development of post-operative atrial fibrillation by regulating inflammation and fibrosis in rats with sterile pericarditis. Int J Mol Med. 2015;36:83–92.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  87. Huang Z, Chen XJ, Qian C, Dong Q, Ding D, Wu QF et al. Signal transducer and activator of transcription 3/microRNA-21 feedback loop contributes to atrial fibrillation by promoting atrial fibrosis in a rat sterile pericarditis model. Circ Arrhythmia Electrophysiol 2016;9.

  88. Ahlsson A, Fengsrud E, Bodin L, Englund A. Postoperative atrial fibrillation in patients undergoing aortocoronary bypass surgery carries an eightfold risk of future atrial fibrillation and a doubled cardiovascular mortality. Eur J Cardio-thorac Surg. 2010;37:1353–9.

    Article  Google Scholar 

  89. Lowres N, Mulcahy G, Gallagher R, Ben Freedman S, Marshman D, Kirkness A, et al. Self-monitoring for atrial fibrillation recurrence in the discharge period post-cardiac surgery using an iPhone electrocardiogram. Eur J Cardio-thorac Surg. 2016;50:44–51.

    Article  Google Scholar 

  90. Cox JL. A perspective of postoperative atrial fibrillation in cardiac operations. Ann Thorac Surg. 1993;56:405–9.

    Article  CAS  PubMed  Google Scholar 

  91. Hertervig EJ, Yuan S, Carlson J, Kongstad-Rasmussen O, Olsson SB. Evidence for electrical remodelling of the atrial myocardium in patients with atrial fibrillation. A study using the monophasic action potential recording technique. Clin Physiol Funct Imaging 2002;22:8–12.

    Article  PubMed  Google Scholar 

  92. Lau CP, Tse HF. Electrical remodelling of chronic atrial fibrillation. Clin Exp Pharmacol Physiol. 1997;24:982–3.

    Article  CAS  PubMed  Google Scholar 

  93. Kertai MD, Li YJ, Ji Y, Qi W, Lombard FW, Shah SH, et al. Genome-wide association study of new-onset atrial fibrillation after coronary artery bypass grafting surgery. Am Heart J. 2015;170(580–90):e28.

    Google Scholar 

  94. Kertai MD, Li YW, Li YJ, Shah SH, Kraus WE, Fontes ML, et al. G protein-coupled receptor kinase 5 gene polymorphisms are associated with postoperative atrial fibrillation after coronary artery bypass grafting in patients receiving beta-blockers. Circ Cardiovasc Genet. 2014;7:625–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Liu L, Zhang L, Liu M, Zhang Y, Han X, Zhang Z. GRK5 polymorphisms and postoperative atrial fibrillation following coronary artery bypass graft surgery. Sci Rep. 2015;5:12768.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  96. Gaudino M, Andreotti F, Zamparelli R, Di Castelnuovo A, Nasso G, Burzotta F et al. The -174G/C interleukin-6 polymorphism influences postoperative interleukin-6 levels and postoperative atrial fibrillation. Is atrial fibrillation an inflammatory complication? Circulation 2003;108 Suppl 1:Ii195–9.

    Article  CAS  Google Scholar 

  97. O’Connor AM, Smith AH, Crum K, Edwards TL, Kannankeril PJ. Analysis of clinical and candidate genetic risk factors for postoperative atrial tachycardia after congenital heart surgery in infants. Am Heart J. 2018;202:1–4.

    Article  PubMed  PubMed Central  Google Scholar 

  98. Jeff JM, Donahue BS, Brown-Gentry K, Roden DM, Crawford DC, Stein CM, et al. Genetic variation in the beta1-adrenergic receptor is associated with the risk of atrial fibrillation after cardiac surgery. Am Heart J. 2014;167(101–08):e1.

    Google Scholar 

  99. Body SC, Collard CD, Shernan SK, Fox AA, Liu KY, Ritchie MD, et al. Variation in the 4q25 chromosomal locus predicts atrial fibrillation after coronary artery bypass graft surgery. Circ Cardiovasc Genet. 2009;2:499–506.

    Article  CAS  PubMed  Google Scholar 

  100. Shen J, Lall S, Zheng V, Buckley P, Damiano RJ Jr, Schuessler RB. The persistent problem of new-onset postoperative atrial fibrillation: a single-institution experience over two decades. J Thorac Cardiovasc Surg. 2011;141:559–70.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Villareal RP, Hariharan R, Liu BC, Kar B, Lee VV, Elayda M, et al. Postoperative atrial fibrillation and mortality after coronary artery bypass surgery. J Am Coll Cardiol. 2004;43:742–8.

    Article  PubMed  Google Scholar 

  102. Zaman AG, Archbold RA, Helft G, Paul EA, Curzen NP, Mills PG. Atrial fibrillation after coronary artery bypass surgery: a model for preoperative risk stratification. Circulation. 2000;101:1403–8.

    Article  CAS  PubMed  Google Scholar 

  103. Banach M, Rysz J, Drozdz JA, Okonski P, Misztal M, Barylski M, et al. Risk factors of atrial fibrillation following coronary artery bypass grafting: a preliminary report. Circ J. 2006;70:438–41.

    Article  PubMed  Google Scholar 

  104. Nazeri A, Razavi M, Elayda MA, Lee VV, Massumi A, Wilson JM. Race/ethnicity and the incidence of new-onset atrial fibrillation after isolated coronary artery bypass surgery. Heart Rhythm. 2010;7:1458–63.

    Article  PubMed  Google Scholar 

  105. Rader F, Van Wagoner DR, Ellinor PT, Gillinov AM, Chung MK, Costantini O, et al. Influence of race on atrial fibrillation after cardiac surgery. Circ Arrhythm Electrophysiol. 2011;4:644–52.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Hashemzadeh K, Dehdilani M, Dehdilani M. Postoperative atrial fibrillation following open cardiac surgery: predisposing factors and complications. J Cardiovasc Thorac Res. 2013;5:101–7.

    PubMed  PubMed Central  Google Scholar 

  107. Hashimoto K, Ilstrup DM, Schaff HV. Influence of clinical and hemodynamic variables on risk of supraventricular tachycardia after coronary artery bypass. J Thorac Cardiovasc Surg. 1991;101:56–65.

    Article  CAS  PubMed  Google Scholar 

  108. Haghjoo M, Basiri H, Salek M, Sadr-Ameli MA, Kargar F, Raissi K, et al. Predictors of postoperative atrial fibrillation after coronary artery bypass graft surgery. Indian Pacing Electrophysiol J. 2008;8:94–101.

    PubMed  PubMed Central  Google Scholar 

  109. Zacharias A, Schwann TA, Riordan CJ, Durham SJ, Shah AS, Habib RH. Obesity and risk of new-onset atrial fibrillation after cardiac surgery. Circulation. 2005;112:3247–55.

    Article  PubMed  Google Scholar 

  110. Gu J, Andreasen JJ, Melgaard J, Lundbye-Christensen S, Hansen J, Schmidt EB, et al. Preoperative electrocardiogram score for predicting new-onset postoperative atrial fibrillation in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth. 2017;31:69–76.

    Article  PubMed  Google Scholar 

  111. Hill LL, Kattapuram M, Hogue CW Jr. Management of atrial fibrillation after cardiac surgery—part I: pathophysiology and risks. J Cardiothorac Vasc Anesth. 2002;16:483–94.

    Article  PubMed  Google Scholar 

  112. Levy F, Debry N, Labescat AL, Meimoun P, Malaquin D, Marechaux S, et al. Echocardiographic prediction of postoperative atrial fibrillation after aortic valve replacement for aortic stenosis: a two-dimensional speckle tracking left ventricular longitudinal strain multicentre pilot study. Arch Cardiovasc Dis. 2012;105:499–506.

    Article  PubMed  Google Scholar 

  113. Wazni OM, Martin DO, Marrouche NF, Latif AA, Ziada K, Shaaraoui M, et al. Plasma B-type natriuretic peptide levels predict postoperative atrial fibrillation in patients undergoing cardiac surgery. Circulation. 2004;110:124–7.

    Article  CAS  PubMed  Google Scholar 

  114. Svagzdiene M, Sirvinskas E, Benetis R, Raliene L, Simatoniene V. Atrial fibrillation and changes in serum and urinary electrolyte levels after coronary artery bypass grafting surgery. Med (Kaunas, Lithuania). 2009;45:960–70.

    Google Scholar 

  115. Ali IM, Sanalla AA, Clark V. Beta-blocker effects on postoperative atrial fibrillation. Eur J Cardio-thorac Surg. 1997;11:1154–7.

    Article  CAS  Google Scholar 

  116. Basaran O, Tigen K, Gozubuyuk G, Dundar C, Guler A, Tasar O, et al. Predictive role of left atrial and ventricular mechanical function in postoperative atrial fibrillation: a two-dimensional speckle-tracking echocardiography study. Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir. 2016;44:45–52.

    Google Scholar 

  117. Gabrielli L, Corbalan R, Cordova S, Enriquez A, Mc Nab P, Verdejo HE, et al. Left atrial dysfunction is a predictor of postcoronary artery bypass atrial fibrillation: association of left atrial strain and strain rate assessed by speckle tracking. Echocardiogr (Mount Kisco, NY). 2011;28:1104–8.

    Article  Google Scholar 

  118. Her AY, Kim JY, Kim YH, Choi EY, Min PK, Yoon YW, et al. Left atrial strain assessed by speckle tracking imaging is related to new-onset atrial fibrillation after coronary artery bypass grafting. Can J Cardiol. 2013;29:377–83.

    Article  PubMed  Google Scholar 

  119. Parsaee M, Moradi B, Esmaeilzadeh M, Haghjoo M, Bakhshandeh H, Sari L. New onset atrial fibrillation after coronary artery bypasses grafting; an evaluation of mechanical left atrial function. Arch Iran Med. 2014;17:501–6.

    PubMed  Google Scholar 

  120. Tayyareci Y, Yildirimturk O, Aytekin V, Memic K, Behramoglu F, Demiroglu IC, et al. Preoperative left atrial mechanical dysfunction predicts postoperative atrial fibrillation after coronary artery bypass graft operation—a velocity vector imaging-based study. Circ J. 2010;74:2109–17.

    Article  PubMed  Google Scholar 

  121. Ngai J, Leonard J, Echevarria G, Neuburger P, Applebaum R. Left atrial appendage velocity as a predictor of atrial fibrillation after cardiac surgery. J Cardiothorac Vasc Anesth. 2016;30:413–7.

    Article  PubMed  Google Scholar 

  122. Hu J, Peng L, Qian H, Li YJ, Meng W, Xiao ZH, et al. Transoesophageal echocardiography for prediction of postoperative atrial fibrillation after isolated aortic valve replacement: two-dimensional speckle tracking for intraoperative assessment of left ventricular longitudinal strain. Eur J Cardio-thorac Surg. 2015;47:833–9.

    Article  Google Scholar 

  123. Levy F, Debry N, Labescat AL, Meimoun P, Malaquin D, Marechaux S, et al. Echocardiographic prediction of postoperative atrial fibrillation after aortic valve replacement for aortic stenosis: a two-dimensional speckle tracking left ventricular longitudinal strain multicentre pilot study. Arch Cardiovasc Dis. 2012;105:499–506.

    Article  PubMed  Google Scholar 

  124. Asher CR, Miller DP, Grimm RA, Cosgrove DM 3rd, Chung MK. Analysis of risk factors for development of atrial fibrillation early after cardiac valvular surgery. Am J Cardiol. 1998;82:892–5.

    Article  CAS  PubMed  Google Scholar 

  125. Anné W, Willems R, Roskams T, Sergeant P, Herijgers P, Holemans P, et al. Matrix metalloproteinases and atrial remodeling in patients with mitral valve disease and atrial fibrillation. Cardiovasc Res. 2005;67:655–66.

    Article  PubMed  CAS  Google Scholar 

  126. Creswell LL, Schuessler RB, Rosenbloom M, Cox JL. Hazards of postoperative atrial arrhythmias. Annals Thorac Surg. 1993;56:539–49.

    Article  CAS  Google Scholar 

  127. Rivinius R, Helmschrott M, Ruhparwar A, Darche FF, Thomas D, Bruckner T, et al. Comparison of posttransplant outcomes in patients with no, acute, or chronic amiodarone use before heart transplantation. Drug Design Dev Therapy. 2017;11:1827–37.

    Article  CAS  Google Scholar 

  128. Alp H, Narin C, Baysal T, Sarigul A. Prevalence of and risk factors for early postoperative arrhythmia in children after cardiac surgery. Pediatr Int. 2014;56:19–23.

    Article  PubMed  Google Scholar 

  129. Sahu MK, Das A, Siddharth B, Talwar S, Singh SP, Abraham A, et al. Arrhythmias in children in early postoperative period after cardiac surgery. World J Pediatr Congenit Heart Surg. 2018;9:38–46.

    Article  PubMed  Google Scholar 

  130. He D, Aggarwal N, Zurakowski D, Jonas RA, Berul CI, Hanumanthaiah S, et al. Lower risk of postoperative arrhythmias in congenital heart surgery following intraoperative administration of magnesium. J Thorac Cardiovasc Surg. 2018;156(763–70):e1.

    Google Scholar 

  131. Caretta Q, Mercanti CA, De Nardo D, Chiarotti F, Scibilia G, Reale A et al. Ventricular conduction defects and atrial fibrillation after coronary artery bypass grafting. Multivariate analysis of preoperative, intraoperative and postoperative variables. Eur Heart J 1991;12:1107–11.

    Article  CAS  PubMed  Google Scholar 

  132. Nair SG. Atrial fibrillation after cardiac surgery. Ann Card Anaesth. 2010;13:196–205.

    Article  PubMed  Google Scholar 

  133. Melduni RM, Schaff HV, Lee HC, Gersh BJ, Noseworthy PA, Bailey KR, et al. Impact of left atrial appendage closure during cardiac surgery on the occurrence of early postoperative atrial fibrillation, stroke, and mortality: a propensity score-matched analysis of 10 633 patients. Circulation. 2017;135:366–78.

    Article  PubMed  Google Scholar 

  134. Yao X, Gersh BJ, Holmes DR Jr, Melduni RM, Johnsrud DO, Sangaralingham LR, et al. Association of surgical left atrial appendage occlusion with subsequent stroke and mortality among patients undergoing cardiac surgery. JAMA. 2018;319:2116–26.

    Article  PubMed  PubMed Central  Google Scholar 

  135. Hoit BD, Shao Y, Tsai LM, Patel R, Gabel M, Walsh RA. Altered left atrial compliance after atrial appendectomy. Influence on left atrial and ventricular filling. Circ Res 1993;72:167–75.

    Article  CAS  PubMed  Google Scholar 

  136. Murphy GJ, Ascione R, Caputo M, Angelini GD. Operative factors that contribute to post-operative atrial fibrillation: insights from a prospective randomized trial. Cardiac electrophysiology review. 2003;7:136–9.

    Article  CAS  PubMed  Google Scholar 

  137. Hogue CW Jr, Creswell LL, Gutterman DD, Fleisher LA. Epidemiology, mechanisms, and risks: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128:9s–16s.

    Article  PubMed  Google Scholar 

  138. Kalus JS, Caron MF, White CM, Mather JF, Gallagher R, Boden WE, et al. Impact of fluid balance on incidence of atrial fibrillation after cardiothoracic surgery. Am J Cardiol. 2004;94:1423–5.

    Article  PubMed  Google Scholar 

  139. Nardi F, Diena M, Caimmi PP, Iraghi G, Lazzero M, Cerin G, et al. Relationship between left atrial volume and atrial fibrillation following coronary artery bypass grafting. J Card Surg. 2012;27:128–35.

    Article  PubMed  Google Scholar 

  140. Chua SK, Shyu KG, Lu MJ, Lien LM, Lin CH, Chao HH, et al. Clinical utility of CHADS2 and CHA2DS2-VASc scoring systems for predicting postoperative atrial fibrillation after cardiac surgery. J Thorac Cardiovasc Surg. 2013;146:919–26e1.

    Article  Google Scholar 

  141. Cameron MJ, Tran DTT, Abboud J, Newton EK, Rashidian H, Dupuis JY. Prospective external validation of three preoperative risk scores for prediction of new onset atrial fibrillation after cardiac surgery. Anesth Analg. 2018;126:33–8.

    Article  PubMed  Google Scholar 

  142. Pollock BD, Filardo G, da Graca B, Phan TK, Ailawadi G, Thourani V, et al. Predicting new-onset post-coronary artery bypass graft atrial fibrillation with existing risk scores. Ann Thorac Surg. 2018;105:115–21.

    Article  PubMed  Google Scholar 

  143. Mariscalco G, Biancari F, Zanobini M, Cottini M, Piffaretti G, Saccocci M, et al. Bedside tool for predicting the risk of postoperative atrial fibrillation after cardiac surgery: the POAF score. J Am Heart Assoc. 2014;3:e000752.

    Article  PubMed  PubMed Central  Google Scholar 

  144. Alonso A, Krijthe BP, Aspelund T, Stepas KA, Pencina MJ, Moser CB, et al. Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population: the CHARGE-AF consortium. J Am Heart Assoc. 2013;2:e000102.

    Article  PubMed  PubMed Central  Google Scholar 

  145. Kolek MJ, Muehlschlegel JD, Bush WS, Parvez B, Murray KT, Stein CM, et al. Genetic and clinical risk prediction model for postoperative atrial fibrillation. Circ Arrhythm Electrophysiol. 2015;8:25–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  146. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014;130:2071–104.

    Article  PubMed  Google Scholar 

  147. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37:2893–962.

    Article  PubMed  Google Scholar 

  148. Gillinov AM, Bagiella E, Moskowitz AJ, Raiten JM, Groh MA, Bowdish ME, et al. Rate control versus rhythm control for atrial fibrillation after cardiac surgery. N Engl J Med. 2016;374:1911–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  149. Arsenault KA, Yusuf AM, Crystal E, Healey JS, Morillo CA, Nair GM et al. Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery. Cochrane Datab Syst Rev 2013:Cd003611.

  150. DiNicolantonio JJ, Beavers CJ, Menezes AR, Lavie CJ, O’Keefe JH, Meier P, et al. Meta-analysis comparing carvedilol versus metoprolol for the prevention of postoperative atrial fibrillation following coronary artery bypass grafting. Am J Cardiol. 2014;113:565–9.

    Article  CAS  PubMed  Google Scholar 

  151. Lopez BL, Christopher TA, Yue TL, Ruffolo R, Feuerstein GZ, Ma XL. Carvedilol, a new beta-adrenoreceptor blocker antihypertensive drug, protects against free-radical-induced endothelial dysfunction. Pharmacology. 1995;51:165–73.

    Article  CAS  PubMed  Google Scholar 

  152. Brinkman W, Herbert MA, O’Brien S, Filardo G, Prince S, Dewey T, et al. Preoperative beta-blocker use in coronary artery bypass grafting surgery: national database analysis. JAMA Internal Med. 2014;174:1320–7.

    Article  Google Scholar 

  153. Wijeysundera DN, Beattie WS, Rao V, Karski J. Calcium antagonists reduce cardiovascular complications after cardiac surgery: a meta-analysis. J Am Coll Cardiol. 2003;41:1496–505.

    Article  CAS  PubMed  Google Scholar 

  154. Tisdale JE, Padhi ID, Goldberg AD, Silverman NA, Webb CR, Higgins RS, et al. A randomized, double-blind comparison of intravenous diltiazem and digoxin for atrial fibrillation after coronary artery bypass surgery. Am Heart J. 1998;135:739–47.

    Article  CAS  PubMed  Google Scholar 

  155. Buckley MS, Nolan PE Jr, Slack MK, Tisdale JE, Hilleman DE, Copeland JG. Amiodarone prophylaxis for atrial fibrillation after cardiac surgery: meta-analysis of dose response and timing of initiation. Pharmacotherapy. 2007;27:360–8.

    Article  CAS  PubMed  Google Scholar 

  156. Chatterjee S, Sardar P, Mukherjee D, Lichstein E, Aikat S. Timing and route of amiodarone for prevention of postoperative atrial fibrillation after cardiac surgery: a network regression meta-analysis. Pacing Clin Electrophysiol. 2013;36:1017–23.

    Article  PubMed  Google Scholar 

  157. Suttorp MJ, Kingma JH, Peels HO, Koomen EM, Tijssen JG, van Hemel NM, et al. Effectiveness of sotalol in preventing supraventricular tachyarrhythmias shortly after coronary artery bypass grafting. Am J Cardiol. 1991;68:1163–9.

    Article  CAS  PubMed  Google Scholar 

  158. VanderLugt JT, Mattioni T, Denker S, Torchiana D, Ahern T, Wakefield LK, et al. Efficacy and safety of ibutilide fumarate for the conversion of atrial arrhythmias after cardiac surgery. Circulation. 1999;100:369–75.

    Article  CAS  PubMed  Google Scholar 

  159. Serafimovski N, Burke P, Khawaja O, Sekulic M, Machado C. Usefulness of dofetilide for the prevention of atrial tachyarrhythmias (atrial fibrillation or flutter) after coronary artery bypass grafting. Am J Cardiol. 2008;101:1574–9.

    Article  CAS  PubMed  Google Scholar 

  160. Torp-Pedersen C, Moller M, Bloch-Thomsen PE, Kober L, Sandoe E, Egstrup K et al. Dofetilide in patients with congestive heart failure and left ventricular dysfunction. Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group. N Engl J Med 1999;341:857–65.

    Article  CAS  Google Scholar 

  161. Laub GW, Janeira L, Muralidharan S, Riebman JB, Chen C, Neary M, et al. Prophylactic procainamide for prevention of atrial fibrillation after coronary artery bypass grafting: a prospective, double-blind, randomized, placebo-controlled pilot study. Crit Care Med. 1993;21:1474–8.

    Article  CAS  PubMed  Google Scholar 

  162. Merrick AF, Odom NJ, Keenan DJ, Grotte GJ. Comparison of propafenone to atenolol for the prophylaxis of postcardiotomy supraventricular tachyarrhythmias: a prospective trial. Eur J Cardio-thorac Surg. 1995;9:146–9.

    Article  CAS  Google Scholar 

  163. Yilmaz AT, Demirkilic U, Arslan M, Kurulay E, Ozal E, Tatar H, et al. Long-term prevention of atrial fibrillation after coronary artery bypass surgery: comparison of quinidine, verapamil, and amiodarone in maintaining sinus rhythm. J Card Surg. 1996;11:61–4.

    Article  CAS  PubMed  Google Scholar 

  164. Gold MR, O’Gara PT, Buckley MJ, DeSanctis RW. Efficacy and safety of procainamide in preventing arrhythmias after coronary artery bypass surgery. Am J Cardiol. 1996;78:975–9.

    Article  CAS  PubMed  Google Scholar 

  165. Fairley JL, Zhang L, Glassford NJ, Bellomo R. Magnesium status and magnesium therapy in cardiac surgery: a systematic review and meta-analysis focusing on arrhythmia prevention. J Crit Care. 2017;42:69–77.

    Article  CAS  PubMed  Google Scholar 

  166. Gholipour Baradari A, Emami Zeydi A, Ghafari R, Aarabi M, Jafari M. A double-blind randomized clinical trial comparing different doses of magnesium in cardioplegic solution for prevention of atrial fibrillation after coronary artery bypass graft surgery. Cardiovasc Ther. 2016;34:276–82.

    Article  CAS  PubMed  Google Scholar 

  167. Bakhsh M, Abbas S, Hussain RM, Ali Khan S, Naqvi SM. Role of magnesium in preventing post-operative atrial fibrillation after coronary artery bypass surgery. J Ayub Med Coll Abbottabad. 2009;21:27–9.

    PubMed  Google Scholar 

  168. Behmanesh S, Tossios P, Homedan H, Hekmat K, Hellmich M, Muller-Ehmsen J, et al. Effect of prophylactic bisoprolol plus magnesium on the incidence of atrial fibrillation after coronary bypass surgery: results of a randomized controlled trial. Curr Med Res Opin. 2006;22:1443–50.

    Article  CAS  PubMed  Google Scholar 

  169. Bert AA, Reinert SE, Singh AK. A beta-blocker, not magnesium, is effective prophylaxis for atrial tachyarrhythmias after coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth. 2001;15:204–9.

    Article  CAS  PubMed  Google Scholar 

  170. Besogul Y, Tunerir B, Ozdemir C, Aslan R. Magnesium-flush infusion into the aortic root just before reperfusion reduces the requirement for internal defibrillation and early post-perfusion arrhythmias. J Int Med Res. 2003;31:202–9.

    Article  CAS  PubMed  Google Scholar 

  171. Bhudia SK, Cosgrove DM, Naugle RI, Rajeswaran J, Lam BK, Walton E, et al. Magnesium as a neuroprotectant in cardiac surgery: a randomized clinical trial. J Thorac Cardiovasc Surg. 2006;131:853–61.

    Article  CAS  PubMed  Google Scholar 

  172. Cagli K, Ozeke O, Ergun K, Budak B, Demirtas E, Birincioglu CL, et al. Effect of low-dose amiodarone and magnesium combination on atrial fibrillation after coronary artery surgery. J Card Surg. 2006;21:458–64.

    Article  PubMed  Google Scholar 

  173. Carrió ML, Ventura JL, Javierre C, Rodriguez-Castro D, Farrero E, Torrado H, et al. Does post-cardiac surgery magnesium supplementation improve outcome? Magnes Res. 2012;25:159–67.

    PubMed  Google Scholar 

  174. Caspi J, Rudis E, Bar I, Safadi T, Saute M. Effects of magnesium on myocardial function after coronary artery bypass grafting. Ann Thorac Surg. 1995;59:942–7.

    Article  CAS  PubMed  Google Scholar 

  175. Colquhoun IW, Berg GA, el-Fiky M, Hurle A, Fell GS, Wheatley DJ. Arrhythmia prophylaxis after coronary artery surgery. A randomised controlled trial of intravenous magnesium chloride. Eur J Cardio-thorac Surg 1993;7:520–3.

    Article  CAS  PubMed  Google Scholar 

  176. Cook RC, Humphries KH, Gin K, Janusz MT, Slavik RS, Bernstein V, et al. Prophylactic intravenous magnesium sulphate in addition to oral {beta}-blockade does not prevent atrial arrhythmias after coronary artery or valvular heart surgery: a randomized, controlled trial. Circulation. 2009;120:S163–9.

    Article  CAS  PubMed  Google Scholar 

  177. Dagdelen S, Toraman F, Karabulut H, Alhan C. The value of P dispersion on predicting atrial fibrillation after coronary artery bypass surgery: effect of magnesium on P dispersion. Ann Noninvasive Electrocardiol 2002;7:211-8.

    Article  PubMed  Google Scholar 

  178. England MR, Gordon G, Salem M, Chernow B. Magnesium administration and dysrhythmias after cardiac surgery. A placebo-controlled, double-blind, randomized trial. JAMA 1992;268:2395-402.

    Article  CAS  PubMed  Google Scholar 

  179. Fanning WJ, Thomas CS Jr, Roach A, Tomichek R, Alford WC, Stoney WS Jr. Prophylaxis of atrial fibrillation with magnesium sulfate after coronary artery bypass grafting. Ann Thorac Surg. 1991;52:529–33.

    Article  CAS  PubMed  Google Scholar 

  180. Forlani S, De Paulis R, de Notaris S, Nardi P, Tomai F, Proietti I et al. Combination of sotalol and magnesium prevents atrial fibrillation after coronary artery bypass grafting. Ann Thorac Surg 2002;74:720–5; (discussion 25–6).

    Article  PubMed  Google Scholar 

  181. Geertman H, van der Starre PJ, Sie HT, Beukema WP, van Rooyen-Butijn M. Magnesium in addition to sotalol does not influence the incidence of postoperative atrial tachyarrhythmias after coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2004;18:309–12.

    Article  CAS  PubMed  Google Scholar 

  182. Hamid M, Kamal RS, Sami SA, Atiq F, Shafquat A, Naqvi HI, et al. Effect of single dose magnesium on arrhythmias in patients undergoing coronary artery bypass surgery. J Pak Med Assoc. 2008;58:22–7.

    PubMed  Google Scholar 

  183. Harris MN, Crowther A, Jupp RA, Aps C. Magnesium and coronary revascularization. Br J Anaesth. 1988;60:779–83.

    Article  CAS  PubMed  Google Scholar 

  184. Hazelrigg SR, Boley TM, Cetindag IB, Moulton KP, Trammell GL, Polancic JE, et al. The efficacy of supplemental magnesium in reducing atrial fibrillation after coronary artery bypass grafting. Ann Thorac Surg. 2004;77:824–30.

    Article  PubMed  Google Scholar 

  185. Jensen BM, Alstrup P, Klitgard NA. Magnesium substitution and postoperative arrhythmias in patients undergoing coronary artery bypass grafting. Scand Cardiovasc J. 1997;31:265–9.

    Article  CAS  PubMed  Google Scholar 

  186. Kaplan M, Kut MS, Icer UA, Demirtas MM. Intravenous magnesium sulfate prophylaxis for atrial fibrillation after coronary artery bypass surgery. J Thorac Cardiovasc Surg. 2003;125:344–52.

    Article  CAS  PubMed  Google Scholar 

  187. Karmy-Jones R, Hamilton A, Dzavik V, Allegreto M, Finegan BA, Koshal A. Magnesium sulfate prophylaxis after cardiac operations. Ann Thorac Surg. 1995;59:502–7.

    Article  CAS  PubMed  Google Scholar 

  188. Kiziltepe U, Eyileten ZB, Sirlak M, Tasoz R, Aral A, Eren NT, et al. Antiarrhythmic effect of magnesium sulfate after open heart surgery: effect of blood levels. Int J Cardiol. 2003;89:153–8.

    Article  PubMed  Google Scholar 

  189. Klinger RY, Thunberg CA, White WD, Fontes M, Waldron NH, Piccini JP, et al. Intraoperative magnesium administration does not reduce postoperative atrial fibrillation after cardiac surgery. Anesth Analg. 2015;121:861–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  190. Laiq N, Khan RA, Mailk A, Ahmad H. Intravenous magnesium prevents atrial fibrillation after valvular heart surgery. J Med Sci. 2013;21:77–80.

    Google Scholar 

  191. Moradian ST, Ghiasi MS, Mohamadpour A, Siavash Y. Oral magnesium supplementation reduces the incidence of gastrointestinal complications following cardiac surgery: a randomized clinical trial. Magnes Res. 2017;30:28–34.

    CAS  PubMed  Google Scholar 

  192. Najafi M, Hamidian R, Haghighat B, Fallah N, Tafti HA, Karimi A, et al. Magnesium infusion and postoperative atrial fibrillation: a randomized clinical trial. Acta Anaesthesiol Taiwanica. 2007;45:89–94.

    Google Scholar 

  193. Nurozler F, Tokgozoglu L, Pasaoglu I, Boke E, Ersoy U, Bozer AY. Atrial fibrillation after coronary artery bypass surgery: predictors and the role of MgSO4 replacement. J Card Surg. 1996;11:421–7.

    Article  CAS  PubMed  Google Scholar 

  194. Parikka H, Toivonen L, Pellinen T, Verkkala K, Jarvinen A, Nieminen MS. The influence of intravenous magnesium sulphate on the occurrence of atrial fibrillation after coronary artery by-pass operation. Eur Heart J. 1993;14:251–8.

    Article  CAS  PubMed  Google Scholar 

  195. Shakerinia T, Ali IM, Sullivan JAP. Magnesium in cardioplegia: is it necessary? Can J Surg. 1996;39:397–400.

    CAS  PubMed  PubMed Central  Google Scholar 

  196. Solomon AJ, Berger AK, Trivedi KK, Hannan RL, Katz NM. The combination of propranolol and magnesium does not prevent postoperative atrial fibrillation. Ann Thorac Surg. 2000;69:126–9.

    Article  CAS  PubMed  Google Scholar 

  197. Speziale G, Ruvolo G, Fattouch K, Macrina F, Tonelli E, Donnetti M, et al. Arrhythmia prophylaxis after coronary artery bypass grafting: regimens of magnesium sulfate administration. Thorac Cardiovasc Surg. 2000;48:22–6.

    Article  CAS  PubMed  Google Scholar 

  198. Taksaudom N, Cheewinmethasiri J, Chittawatanarat K, Nawarawong W, Ko-iam W, Sudthiviseschai P. Magnesium sulfate reduces incidence of atrial fibrillation after coronary arterial bypass surgery: what is the proper dose? A randomized trial. J Med Assoc Thailand Chotmaihet Thangphaet 2016;99:794–801.

  199. Toraman F, Karabulut EH, Alhan HC, Dagdelen S, Tarcan S. Magnesium infusion dramatically decreases the incidence of atrial fibrillation after coronary artery bypass grafting. Ann Thorac Surg 2001;72:1256–61; (discussion 61–2).

    Article  CAS  PubMed  Google Scholar 

  200. Treggiari-Venzi MM, Waeber JL, Perneger TV, Suter PM, Adamec R, Romand JA. Intravenous amiodarone or magnesium sulphate is not cost-beneficial prophylaxis for atrial fibrillation after coronary artery bypass surgery. Br J Anaesth. 2000;85:690–5.

    Article  CAS  PubMed  Google Scholar 

  201. Wilkes NJ, Mallett SV, Peachey T, Di Salvo C, Walesby R. Correction of ionized plasma magnesium during cardiopulmonary bypass reduces the risk of postoperative cardiac arrhythmia. Anesthesia Analgesia 2002;95:828–34, (table of contents).

    CAS  Google Scholar 

  202. Wistbacka JO, Koistinen J, Karlqvist KE, Lepojarvi MV, Hanhela R, Laurila J, et al. Magnesium substitution in elective coronary artery surgery: a double-blind clinical study. J Cardiothorac Vasc Anesth. 1995;9:140–6.

    Article  CAS  PubMed  Google Scholar 

  203. Zangrillo A, Landoni G, Sparicio D, Pappalardo F, Bove T, Cerchierini E, et al. Perioperative magnesium supplementation to prevent atrial fibrillation after off-pump coronary artery surgery: a randomized controlled study. J Cardiothorac Vasc Anesth. 2005;19:723–8.

    Article  CAS  PubMed  Google Scholar 

  204. Rezaei Y, Samiei N, Hosseini S. Do statins attenuate postoperative atrial fibrillation in isolated heart valve surgery? Pharmacotherapy. 2016;36:e16–7.

    Article  PubMed  Google Scholar 

  205. Zheng Z, Jayaram R, Jiang L, Emberson J, Zhao Y, Li Q, et al. Perioperative rosuvastatin in cardiac surgery. N Engl J Med. 2016;374:1744–53.

    Article  CAS  PubMed  Google Scholar 

  206. Billings FTt, Hendricks PA, Schildcrout JS, Shi Y, Petracek MR, Byrne JG et al. High-Dose Perioperative Atorvastatin and Acute Kidney Injury Following Cardiac Surgery: A Randomized Clinical Trial. JAMA 2016;315:877–88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  207. Yuan X, Du J, Liu Q, Zhang L. Defining the role of perioperative statin treatment in patients after cardiac surgery: a meta-analysis and systematic review of 20 randomized controlled trials. Int J Cardiol. 2017;228:958–66.

    Article  PubMed  Google Scholar 

  208. Almansob MA, Xu B, Zhou L, Hu XX, Chen W, Chang FJ, et al. Simvastatin reduces myocardial injury undergoing noncoronary artery cardiac surgery: a randomized controlled trial. Arterioscler Thromb Vasc Biol. 2012;32:2304–13.

    Article  CAS  PubMed  Google Scholar 

  209. Antoniades C, Demosthenous M, Reilly S, Margaritis M, Zhang MH, Antonopoulos A, et al. Myocardial redox state predicts in-hospital clinical outcome after cardiac surgery effects of short-term pre-operative statin treatment. J Am Coll Cardiol. 2012;59:60–70.

    Article  CAS  PubMed  Google Scholar 

  210. Aydin U, Yilmaz M, Duzyol C, Ata Y, Turk T, Orhan AL, et al. Efficiency of postoperative statin treatment for preventing new-onset postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting: a prospective randomized study. Anatol J Cardiol. 2015;15:491–5.

    Article  CAS  PubMed  Google Scholar 

  211. Baran Ç, Durdu S, Dalva K, Zaim Ç, Dogan A, Ocakoglu G, et al. Effects of preoperative short term use of atorvastatin on endothelial progenitor cells after coronary surgery: a randomized, controlled trial. Stem Cell Rev Rep. 2012;8:963–71.

    Article  CAS  PubMed  Google Scholar 

  212. Berkan O, Katrancioglu N, Ozker E, Ozerdem G, Bakici Z, Yilmaz MB. Reduced P-selectin in hearts pretreated with fluvastatin: a novel benefit for patients undergoing open heart surgery. Thorac Cardiovasc Surg. 2009;57:91–5.

    Article  CAS  PubMed  Google Scholar 

  213. Caorsi C, Pineda F, Munoz C. Pravastatin immunomodulates IL-6 and C-reactive protein, but not IL-1 and TNF-alpha, in cardio-pulmonary bypass. Eur Cytokine Netw. 2008;19:99–103.

    CAS  PubMed  Google Scholar 

  214. Chello M, Patti G, Candura D, Mastrobuoni S, Di Sciascio G, Agro F, et al. Effects of atorvastatin on systemic inflammatory response after coronary bypass surgery. Crit Care Med. 2006;34:660–7.

    Article  CAS  PubMed  Google Scholar 

  215. Ji Q, Mei Y, Wang X, Sun Y, Feng J, Cai J, et al. Effect of preoperative atorvastatin therapy on atrial fibrillation following off-pump coronary artery bypass grafting. Circ J. 2009;73:2244–9.

    Article  CAS  PubMed  Google Scholar 

  216. Mannacio VA, Iorio D, De Amicis V, Di Lello F, Musumeci F. Effect of rosuvastatin pretreatment on myocardial damage after coronary surgery: a randomized trial. J Thorac Cardiovasc Surg. 2008;136:1541–7.

    Article  PubMed  Google Scholar 

  217. Park JH, Shim J-K, Song J-W, Soh S, Kwak Y-L. Effect of atorvastatin on the incidence of acute kidney injury following valvular heart surgery: a randomized, placebo-controlled trial. Intensive Care Med. 2016;42:1398–407.

    Article  CAS  PubMed  Google Scholar 

  218. Carrascal Y, Arnold RJ, De la Fuente L, Revilla A, Sevilla T, Arce N, et al. Efficacy of atorvastatin in prevention of atrial fibrillation after heart valve surgery in the PROFACE trial (PROphylaxis of postoperative atrial Fibrillation After Cardiac surgEry). J Arrhyth. 2016;32:191–7.

    Article  Google Scholar 

  219. Song YB, On YK, Kim JH, Shin DH, Kim JS, Sung J, et al. The effects of atorvastatin on the occurrence of postoperative atrial fibrillation after off-pump coronary artery bypass grafting surgery. Am Heart J. 2008;156(373):e9–16.

    Google Scholar 

  220. Spadaccio C, Pollari F, Casacalenda A, Alfano G, Genovese J, Covino E, et al. Atorvastatin increases the number of endothelial progenitor cells after cardiac surgery: a randomized control study. J Cardiovasc Pharmacol. 2010;55:30–8.

    Article  CAS  PubMed  Google Scholar 

  221. Sun YF, Ji QA, Mei YQ, Wang XS, Feng J, Cai JZ, et al. Role of preoperative atorvastatin administration in protection against postoperative atrial fibrillation following conventional coronary artery bypass grafting. Int Heart J. 2011;52:7–11.

    Article  CAS  PubMed  Google Scholar 

  222. Tamayo E, Alvarez FJ, Alonso O, Bustamante R, Castrodeza J, Soria S, et al. Effects of simvastatin on systemic inflammatory responses after cardiopulmonary bypass. J Cardiovasc Surg (Torino). 2009;50:687–94.

    CAS  Google Scholar 

  223. Vukovic PM, Maravic-Stojkovic VR, Peric MS, Jovic MD, Cirkovic MV, Gradinac SD, et al. Steroids and statins: an old and a new anti-inflammatory strategy compared. Perfusion-UK. 2011;26:31–7.

    Article  Google Scholar 

  224. Zheng Z, Jayaram R, Jiang LX, Emberson J, Zhao Y, Li Q, et al. Perioperative rosuvastatin in cardiac surgery. N Engl J Med. 2016;374:1744–53.

    Article  CAS  PubMed  Google Scholar 

  225. Park J, Lee JH, Kim KA, Lee SH, Lee YT, Kim WS, et al. Effects of preoperative statin on acute kidney injury after off-pump coronary artery bypass grafting. J Am Heart Assoc. 2019;8:e010892.

    PubMed  PubMed Central  Google Scholar 

  226. Dehghani MR, Madjidi N, Rahmani A, Asgari B, Rezaei Y. Effect of oral vitamin C on atrial fibrillation development after isolated coronary artery bypass grafting surgery: a prospective randomized clinical trial. Cardiol J. 2014;21:492–9.

    Article  PubMed  Google Scholar 

  227. Hemila H, Suonsyrja T. Vitamin C for preventing atrial fibrillation in high risk patients: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2017;17:49.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  228. Rodrigo R, Korantzopoulos P, Cereceda M, Asenjo R, Zamorano J, Villalabeitia E, et al. A randomized controlled trial to prevent post-operative atrial fibrillation by antioxidant reinforcement. J Am Coll Cardiol. 2013;62:1457–65.

    Article  CAS  PubMed  Google Scholar 

  229. Mozaffarian D, Marchioli R, Macchia A, Silletta MG, Ferrazzi P, Gardner TJ, et al. Fish oil and postoperative atrial fibrillation: the Omega-3 Fatty Acids for Prevention of Post-operative Atrial Fibrillation (OPERA) randomized trial. JAMA. 2012;308:2001–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  230. Sorice M, Tritto FP, Sordelli C, Gregorio R, Piazza L. N-3 polyunsaturated fatty acids reduces post-operative atrial fibrillation incidence in patients undergoing “on-pump” coronary artery bypass graft surgery. Monaldi Arch Chest Dis 2011;76:93–8.

  231. Sandesara CM, Chung MK, Van Wagoner DR, Barringer TA, Allen K, Ismail HM, et al. A randomized, placebo-controlled trial of omega-3 fatty acids for inhibition of supraventricular arrhythmias after cardiac surgery: the FISH trial. J Am Heart Assoc. 2012;1:e000547.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  232. Mariscalco G, Sarzi Braga S, Banach M, Borsani P, Bruno VD, Napoleone M, et al. Preoperative n-3 polyunsatured fatty acids are associated with a decrease in the incidence of early atrial fibrillation following cardiac surgery. Angiology. 2010;61:643–50.

    Article  CAS  PubMed  Google Scholar 

  233. Vasheghani Farahani A, Yousefi Azar A, Goodarzynejad HR, Khorrami E, Hosseinzadeh-Attar MJ, Oshnouei S, et al. Fish oil supplementation for primary prevention of atrial fibrillation after coronary artery bypass graft surgery: A randomized clinical trial. International journal of surgery (London, England). 2017;42:41–8.

    Article  Google Scholar 

  234. Heidt MC, Vician M, Stracke SK, Stadlbauer T, Grebe MT, Boening A, et al. Beneficial effects of intravenously administered N-3 fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a prospective randomized study. Thorac Cardiovasc Surg. 2009;57:276–80.

    Article  CAS  PubMed  Google Scholar 

  235. Wang H, Chen J, Zhao L. N-3 polyunsaturated fatty acids for prevention of postoperative atrial fibrillation: updated meta-analysis and systematic review. J Intervent Cardiac Electrophysiol. 2018;51:105–15.

    Article  Google Scholar 

  236. Mirhosseini SJ, Forouzannia SK, Sayegh AH, Sanatkar M. Effect of prophylactic low dose of methylprednisolone on postoperative new atrial fibrillation and early complications in patients with severe LV dysfunction undergoing elective off-pump coronary artery bypass surgery. Acta Med Iran. 2011;49:288–92.

    PubMed  Google Scholar 

  237. Prasongsukarn K, Abel JG, Jamieson WR, Cheung A, Russell JA, Walley KR, et al. The effects of steroids on the occurrence of postoperative atrial fibrillation after coronary artery bypass grafting surgery: a prospective randomized trial. J Thorac Cardiovasc Surg. 2005;130:93–8.

    Article  CAS  PubMed  Google Scholar 

  238. Dieleman JM, Nierich AP, Rosseel PM, van der Maaten JM, Hofland J, Diephuis JC, et al. Intraoperative high-dose dexamethasone for cardiac surgery: a randomized controlled trial. JAMA. 2012;308:1761–7.

    Article  PubMed  Google Scholar 

  239. Whitlock RP, Devereaux PJ, Teoh KH, Lamy A, Vincent J, Pogue J, et al. Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): a randomised, double-blind, placebo-controlled trial. Lancet (Lond, Engl). 2015;386:1243–53.

    Article  CAS  Google Scholar 

  240. Dvirnik N, Belley-Cote EP, Hanif H, Devereaux PJ, Lamy A, Dieleman JM, et al. Steroids in cardiac surgery: a systematic review and meta-analysis. Br J Anaesth. 2018;120:657–67.

    Article  CAS  PubMed  Google Scholar 

  241. Ozaydin M, Icli A, Yucel H, Akcay S, Peker O, Erdogan D et al. Metoprolol vs. carvedilol or carvedilol plus N-acetyl cysteine on post-operative atrial fibrillation: a randomized, double-blind, placebo-controlled study. Eur Heart J 2013;34:597–604.

    Article  PubMed  CAS  Google Scholar 

  242. Kazemi B, Akbarzadeh F, Safaei N, Yaghoubi A, Shadvar K, Ghasemi K. Prophylactic high-dose oral-N-acetylcysteine does not prevent atrial fibrillation after heart surgery: a prospective double blind placebo-controlled randomized clinical trial. Pacing Clin Electrophysiol. 2013;36:1211–9.

    PubMed  Google Scholar 

  243. Soleimani A, Habibi MR, Hasanzadeh Kiabi F, Alipour A, Habibi V, Azizi S, et al. The effect of intravenous N-acetylcysteine on prevention of atrial fibrillation after coronary artery bypass graft surgery: a double-blind, randomised, placebo-controlled trial. Kardiol Polska. 2018;76:99–106.

    PubMed  Google Scholar 

  244. Ali- Hasan- Al- Saegh S, Mirhosseini SJ, Tahernejad M, Mahdavi P, Shahidzadeh A, Karimi-Bondarabadi AA et al. Impact of antioxidant supplementations on cardio-renal protection in cardiac surgery: an updated and comprehensive meta-analysis and systematic review. Cardiovasc Therapeutics 2016;34:360–70.

    Article  CAS  Google Scholar 

  245. Imazio M, Brucato A, Ferrazzi P, Pullara A, Adler Y, Barosi A, et al. Colchicine for prevention of postpericardiotomy syndrome and postoperative atrial fibrillation: the COPPS-2 randomized clinical trial. JAMA. 2014;312:1016–23.

    Article  CAS  PubMed  Google Scholar 

  246. Imazio M, Brucato A, Ferrazzi P, Rovere ME, Gandino A, Cemin R, et al. Colchicine reduces postoperative atrial fibrillation: results of the Colchicine for the Prevention of the Postpericardiotomy Syndrome (COPPS) atrial fibrillation substudy. Circulation. 2011;124:2290–5.

    Article  CAS  PubMed  Google Scholar 

  247. Lennerz C, Barman M, Tantawy M, Sopher M, Whittaker P. Colchicine for primary prevention of atrial fibrillation after open-heart surgery: systematic review and meta-analysis. Int J Cardiol. 2017;249:127–37.

    Article  PubMed  Google Scholar 

  248. Vizzardi E, D’Aloia A, Quinzani F, Bonadei I, Rovetta R, Bontempi L, et al. A focus on antiarrhythmic properties of ranolazine. J Cardiovasc Pharmacol Therapeutics. 2012;17:353–6.

    Article  CAS  Google Scholar 

  249. Simopoulos V, Tagarakis GI, Daskalopoulou SS, Daskalopoulos ME, Lenos A, Chryssagis K, et al. Ranolazine enhances the antiarrhythmic activity of amiodarone by accelerating conversion of new-onset atrial fibrillation after cardiac surgery. Angiology. 2014;65:294–7.

    Article  CAS  PubMed  Google Scholar 

  250. Simopoulos V, Hevas A, Hatziefthimiou A, Dipla K, Skoularigis I, Tsilimingas N et al. Amiodarone plus ranolazine for conversion of post-cardiac surgery atrial fibrillation: enhanced effectiveness in reduced versus preserved ejection fraction patients. 2018.

  251. Hammond DA, Smotherman C, Jankowski CA, Tan S, Osian O, Kraemer D, et al. Short-course of ranolazine prevents postoperative atrial fibrillation following coronary artery bypass grafting and valve surgeries. Clin Res Cardiol. 2015;104:410–7.

    Article  CAS  PubMed  Google Scholar 

  252. Fedida D, Orth PM, Chen JY, Lin S, Plouvier B, Jung G, et al. The mechanism of atrial antiarrhythmic action of RSD1235. J Cardiovasc Electrophysiol. 2005;16:1227–38.

    Article  PubMed  Google Scholar 

  253. Kowey PR, Dorian P, Mitchell LB, Pratt CM, Roy D, Schwartz PJ, et al. Vernakalant hydrochloride for the rapid conversion of atrial fibrillation after cardiac surgery: a randomized, double-blind, placebo-controlled trial. Circ Arrhythm Electrophysiol. 2009;2:652–9.

    Article  PubMed  Google Scholar 

  254. Dalyanoglu H, Mehdiani A, Minol JP, Sipahi NF, Aubin H, Boeken U, et al. Conversion of atrial fibrillation after cardiosurgical procedures by vernakalant(R) as an atrial repolarization delaying agent (ARDA). Heart Surg Forum. 2018;21:E201-e08.

    Article  Google Scholar 

  255. Steinberg JS, Zelenkofske S, Wong SC, Gelernt M, Sciacca R, Menchavez E. Value of the P-wave signal-averaged ECG for predicting atrial fibrillation after cardiac surgery. Circulation. 1993;88:2618–22.

    Article  CAS  PubMed  Google Scholar 

  256. Greenberg MD, Katz NM, Iuliano S, Tempesta BJ, Solomon AJ. Atrial pacing for the prevention of atrial fibrillation after cardiovascular surgery. J Am Coll Cardiol. 2000;35:1416–22.

    Article  CAS  PubMed  Google Scholar 

  257. Levy T, Fotopoulos G, Walker S, Rex S, Octave M, Paul V, et al. Randomized controlled study investigating the effect of biatrial pacing in prevention of atrial fibrillation after coronary artery bypass grafting. Circulation. 2000;102:1382–7.

    Article  CAS  PubMed  Google Scholar 

  258. Gerstenfeld EP, Hill MR, French SN, Mehra R, Rofino K, Vander Salm TJ, et al. Evaluation of right atrial and biatrial temporary pacing for the prevention of atrial fibrillation after coronary artery bypass surgery. J Am Coll Cardiol. 1999;33:1981–8.

    Article  CAS  PubMed  Google Scholar 

  259. Chung MK, Augostini RS, Asher CR, Pool DP, Grady TA, Zikri M, et al. Ineffectiveness and potential proarrhythmia of atrial pacing for atrial fibrillation prevention after coronary artery bypass grafting. Ann Thorac Surg. 2000;69:1057–63.

    Article  CAS  PubMed  Google Scholar 

  260. Naghnaeian M, Samienasab M, Mirmohammadsadeghi M, Rabani M, Pourmoghaddas A, Behnemun M. The incidence of in-hospital atrial fibrillation after coronary artery bypass grafting using ventricular and atrial pacing. ARYA Atherosclerosis. 2013;9:11–5.

    PubMed  PubMed Central  Google Scholar 

  261. Bidar E, Maesen B, Nieman F, Verheule S, Schotten U, Maessen JG. A prospective randomized controlled trial on the incidence and predictors of late-phase postoperative atrial fibrillation up to 30 days and the preventive value of biatrial pacing. Heart Rhythm. 2014;11:1156–62.

    Article  PubMed  Google Scholar 

  262. Maaroos M, Halonen J, Kiviniemi V, Hartikainen J, Hakala T. Intravenous metoprolol versus biatrial pacing in the prevention of atrial fibrillation after coronary artery bypass surgery: a prospective randomized open trial. Scand J Surg. 2012;101:292–6.

    Article  CAS  PubMed  Google Scholar 

  263. Shea J, Sodhi G, Najam F, Solomon AJ. Does the addition of atrial pacing to amiodarone reduce the incidence of postoperative atrial fibrillation: a pilot study. J Thorac Cardiovasc Surg. 2014;148:1752–3.

    Article  PubMed  Google Scholar 

  264. Kuralay E, Ozal E, Demirkili U, Tatar H. Effect of posterior pericardiotomy on postoperative supraventricular arrhythmias and late pericardial effusion (posterior pericardiotomy). J Thorac Cardiovasc Surg. 1999;118:492–5.

    Article  CAS  PubMed  Google Scholar 

  265. Biancari F, Mahar MA. Meta-analysis of randomized trials on the efficacy of posterior pericardiotomy in preventing atrial fibrillation after coronary artery bypass surgery. J Thorac Cardiovasc Surg. 2010;139:1158–61.

    Article  PubMed  Google Scholar 

  266. McKeown P, Epstein AE. Future directions: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128:61s–4s.

    Article  PubMed  Google Scholar 

  267. Weber MA, Hasford J, Taillens C, Zitzmann A, Hahalis G, Seggewiss H, et al. Low-dose aspirin versus anticoagulants for prevention of coronary graft occlusion. Am J Cardiol. 1990;66:1464–8.

    Article  CAS  PubMed  Google Scholar 

  268. Lahtinen J, Biancari F, Salmela E, Mosorin M, Satta J, Rainio P, et al. Postoperative atrial fibrillation is a major cause of stroke after on-pump coronary artery bypass surgery. Ann Thorac Surg. 2004;77:1241–4.

    Article  PubMed  Google Scholar 

  269. Anderson E, Johnke K, Leedahl D, Glogoza M, Newman R, Dyke C. Novel oral anticoagulants vs warfarin for the management of postoperative atrial fibrillation: clinical outcomes and cost analysis. Am J Surg 2015;210:1095–102; (discussion 102–3).

    Article  PubMed  Google Scholar 

  270. Sezai A, Osaka S, Yaoita H, Arimoto M, Hata H, Shiono M. Safety of the direct oral anticoagulant edoxaban for atrial fibrillation after cardiac surgery: pilot study. J Atrial Fibrill. 2016;9:1456.

    Article  Google Scholar 

  271. Friedman DJ, Piccini JP, Wang T, Zheng J, Malaisrie SC, Holmes DR, et al. Association between left atrial appendage occlusion and readmission for thromboembolism among patients with atrial fibrillation undergoing concomitant cardiac surgery. JAMA. 2018;319:365–74.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-e-Asr Avenue, Tehran, 1995614331, Iran

    Yousef Rezaei, Mohammad Mehdi Peighambari, Shayan Naghshbandi, Niloufar Samiei, Alireza Alizadeh Ghavidel & Saeid Hosseini

  2. Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran

    Mohammad Reza Dehghani

  3. Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

    Majid Haghjoo

Authors
  1. Yousef Rezaei
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammad Mehdi Peighambari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shayan Naghshbandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Niloufar Samiei
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alireza Alizadeh Ghavidel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mohammad Reza Dehghani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Majid Haghjoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Saeid Hosseini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohammad Mehdi Peighambari.

Ethics declarations

Funding

No external funding was used in the preparation of this manuscript.

Conflicts of Interest

YR, MMP, SN, NS, AAG, MRD, MH, and SH declare that they have no potential conflicts of interest that might be relevant to the contents of this manuscript.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rezaei, Y., Peighambari, M.M., Naghshbandi, S. et al. Postoperative Atrial Fibrillation Following Cardiac Surgery: From Pathogenesis to Potential Therapies. Am J Cardiovasc Drugs 20, 19–49 (2020). https://doi.org/10.1007/s40256-019-00365-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40256-019-00365-1

Search

Navigation