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Published in: Surgery Today 8/2020

01-08-2020 | Heart Surgery | Original Article

Tolvaptan can limit postoperative paroxysmal atrial fibrillation occurrence after open-heart surgery

Authors: Yoshinobu Nakamura, Yuichirou Kishimoto, Shingo Harada, Takeshi Onohara, Yuki Otsuki, Hiromu Horie, Motonobu Nishimura

Published in: Surgery Today | Issue 8/2020

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Abstract

Purpose

Tolvaptan administration in the early postoperative period after cardiac surgery rapidly treats fluid retention without affecting the renal function. Tolvaptan also has the benefit of not stimulating the renin–angiotensin and sympathetic nervous systems, which are risk factors for postoperative paroxysmal atrial fibrillation. In this study, we examined the hypothesis that tolvaptan administration reduces postoperative paroxysmal atrial fibrillation and worsening of the renal function incidence in patients who have undergone open-heart surgery.

Methods

From our previous randomized study, we selected 166 open-heart surgery patients, divided them into 2 groups [tolvaptan group, 83 patients; control (non-tolvaptan) group, 83 patients], and compared the incidence of postoperative paroxysmal atrial fibrillation and worsening of the renal function in the postoperative period between the groups.

Results

The incidence of worsening of the renal function was significantly lower in the tolvaptan group than in the control group (4.8% vs. 15.7%; P = 0.04). The incidence of postoperative paroxysmal atrial fibrillation within 14 days was also significantly lower in the tolvaptan group than in the control group (26.5% vs. 42.2%; P = 0.011).

Conclusion

Tolvaptan administration in the early postoperative period after open-heart surgery may reduce the incidence of postoperative paroxysmal atrial fibrillation and worsening of the renal function.
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Metadata
Title
Tolvaptan can limit postoperative paroxysmal atrial fibrillation occurrence after open-heart surgery
Authors
Yoshinobu Nakamura
Yuichirou Kishimoto
Shingo Harada
Takeshi Onohara
Yuki Otsuki
Hiromu Horie
Motonobu Nishimura
Publication date
01-08-2020
Publisher
Springer Singapore
Published in
Surgery Today / Issue 8/2020
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-01962-3

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