Original articleAdult cardiacEarly Restoration of Atrial Contractility After New-Onset Atrial Fibrillation in Off-Pump Coronary Revascularization
Section snippets
Patient Characteristics
The study protocol was approved by the institutional review board (approval number, H-0811-076-263), and informed consents were obtained in all study patients. Of the 338 consecutive patients who underwent isolated OPCAB between January 2009 and December 2010, 69 patients (20.4%) experienced new-onset AF after surgery. Patient inclusion criteria included (1) patients who underwent isolated OPCAB, (2) patients who experienced new-onset AF after surgery, and (3) patients who returned to sinus
Clinical Results
There was no in-hospital mortality, and none of the patients experienced acute renal failure, mediastinitis, or stroke (Table 2). New-onset AF occurred at postoperative 2.3 ± 1.2 days (range, 0 to 6 days), and continued or recurrently occurred for 26 ± 31 hours (range, 1 to 151 hours; >24 hours in 11 and >48 hours in 11; Fig 1). None of the patients underwent electrical cardioversion. Bleeding complications associated with anticoagulation did not occur, and none of the patients experienced
Comment
The present study demonstrated three main findings. First, normal sinus rhythm was restored in most patients with new-onset AF after OPCAB. Second, right and left atrial contractility was restored early after restoration of normal sinus rhythm in patients with new-onset AF. Third, anticoagulation therapy could be discontinued before hospital discharge if normal sinus rhythm was restored and maintained.
Postoperative AF usually develops within the first 4 postoperative days, having a peak
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