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COMMENTS ON PUBLISHED ARTICLE
Year : 2019  |  Volume : 63  |  Issue : 6  |  Page : 511  

Risk factors for postoperative atrial fibrillation


Department of Cardiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey

Date of Web Publication11-Jun-2019

Correspondence Address:
Dr. Yusuf Z Sener
Department of Cardiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_858_18

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How to cite this article:
Sener YZ, Okşul M, Hekimsoy V. Risk factors for postoperative atrial fibrillation. Indian J Anaesth 2019;63:511

How to cite this URL:
Sener YZ, Okşul M, Hekimsoy V. Risk factors for postoperative atrial fibrillation. Indian J Anaesth [serial online] 2019 [cited 2019 Jun 19];63:511. Available from: http://www.ijaweb.org/text.asp?2019/63/6/510/259952



Sir,

We have read with interest the article about the assessment of risk factors for new-onset atrial fibrillation (AF) after cardiac surgery, by Dave et al. They reported that prior reduced ejection fraction, presence of history of myocardial infarction, extended cardiopulmonary by-pass, and ventilatory duration are associated with AF, while the use of beta-blocking agents are protective from AF.[1]

There are several studies on postoperative atrial fibrillation (POAF) and lots of well-defined predictive factors. Use of some medications, such as beta-blocking agents, angiotensin converting enzyme (ACE) inhibitors, statins, and glucocorticoids, is protective toward POAF. Postoperative inflammation is one of the causes of AF, so glucocorticoids and statins have beneficial effects via reducing inflammation. ACE inhibitors reverse atrial remodeling and improve diastolic function by decreasing afterload preventing POAF by reducing atrial pressures and fibrosis.[2]

Left atrial dysfunction is another underlying mechanism of POAF and peak atrial longitudinal strain and peak atrial contraction strain of left atrium is significantly related with POAF. Hideayet et al. impressed that left atrial volume index is also an independent predictor of POAF.[3],[4]

In conclusion, POAF is a frequent complication of cardiac and noncardiac surgery. There are several risk factors for POAF, including medications and left atrial function, which should be considered preoperatively to help predict POAF.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Dave S, Nirgude A, Gujjar P, Sharma R. Incidence and risk factors for development of atrial fibrillation after cardiac surgery under cardiopulmonary bypass. Indian J Anaesth. 2018;62:887-891.  Back to cited text no. 1
    
2.
Yadava M, Hughey AB, Crawford TC. Postoperative atrial fibrillation incidence, mechanisms, and clinical correlates. Heart Fail Clin 2016;12:299-308.  Back to cited text no. 2
    
3.
Hidayet Ş, Yaǧmur J, Bayramoǧlu A, Taşolar MH, Kurtoǧlu E, Özyalın F. Prediction of postoperative atrial fibrillation with left atrial mechanical functions and NT-pro ANP levels after coronary artery bypass surgery: A three-dimensional echocardiography study. Echocardiography 2018;35:661-6.  Back to cited text no. 3
    
4.
Pernigo M, Benfari G, Geremia G, Noni M, Borio G, Mazzali G, et al. Undergoing aortic valve surgery for severe aortic stenosis. J Am Soc Echocardiogr 2017;30:956-65.e1.  Back to cited text no. 4
    




 

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