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General Thoracic and Cardiovascular Surgery

Published in:

01-04-2017 | Original Article

Atrial fibrillation following aortic valve replacement: impact of perioperative use of intravenous β-blocker

Authors: Junki Yokota, Hiroyuki Nishi, Naosumi Sekiya, Mitsutomo Yamada, Toshiki Takahashi

Published in: General Thoracic and Cardiovascular Surgery | Issue 4/2017

Abstract

Objectives

Despite recent advances in perioperative management, postoperative atrial fibrillation/flutter (POAF) remains the most common complication after cardiac surgery. Therefore, it is important to determine related risk factors to establish effective management. However, most studies have focused on patients undergoing coronary artery bypass grafting and little is known about POAF in those who receive aortic valve replacement (AVR). We investigated the relationship of clinical predictors with POAF in patients undergoing AVR.

Methods

A total of 119 patients who underwent AVR were enrolled in this study, and the relationships between POAF incidence and perioperative (preoperative, operative, postoperative) factors were examined.

Results

POAF occurred in 47 patients (40%). In univariate analysis, older age was significantly associated with POAF occurrence, which was significantly related to prolonged intensive care unit (ICU) stay and postoperative stroke. It also showed patients with preoperative β-blocker experienced POAF less frequently than those without β-blocker. Multivariate analysis showed that preoperative β-blocker usage was an independent predictor of POAF. In patients who received both preoperative oral and postoperative intravenous β-blocker administrations, the incidence of POAF was reduced to 14% (3/22).

Conclusions

POAF frequently occurred in patients undergoing AVR, and was significantly related to prolonged ICU stay and postoperative stroke. Our findings show that advanced age and absence of preoperative β-blocker usage are risk factors for POAF. Furthermore, in patients undergoing AVR, perioperative intravenous β-blocker administration may be useful for prevention.

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Title: Atrial fibrillation following aortic valve replacement: impact of perioperative use of intravenous β-blocker
Authors: Junki Yokota
Hiroyuki Nishi
Naosumi Sekiya
Mitsutomo Yamada
Toshiki Takahashi
Publication date: 01-04-2017
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 4/2017
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-016-0738-9

At a glance: The STEP trials

Springer Medicine

Atrial fibrillation following aortic valve replacement: impact of perioperative use of intravenous β-blocker

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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