Universität zu Köln

Zeriouh, Mohamed, Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Choi, Yeong-Hoon, Fatullayev, Javid, Reuter, Hannes, Popov, Aron-Frederik ORCID: 0000-0003-4226-3004, Langebartels, Georg, Kimmig, Lucas ORCID: 0000-0001-8297-0278, Rahmanian, Parwis B. ORCID: 0000-0002-3978-9251, Wittwer, Thorsten, Neef, Klaus, Wippermann, Jens and Wahlers, Thorsten (2014). A novel treatment strategy of new onset atrial fibrillation after cardiac surgery: an observational prospective study. J. Cardiothorac. Surg., 9. LONDON: BMC. ISSN 1749-8090

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Abstract

Objective: The aim of this prospective observational study was to evaluate the efficiency of a new escalating treatment strategy with vernakalant, flecainide and electrical cardioversion (EC) in patients with new onset atrial fibrillation (AF) after cardiac surgery. Material and methods: 24 patients with new onset AF after aortic valve surgery, coronary artery bypass surgery or combined procedures were evaluated in this study. Additional including criteria were age between 18 and 80, duration of AF less than four days, body weight less than 100 kg and no previous treatment with class I or III antiarrhythmic drugs. Exclusion criteria were poor left ventricular ejection fraction (LVEF < 40%) and history of myocardial infarction within 30 days. The patients were divided into converters and non-converters according to their response to combination treatment with vernakalant and flecainide, and the groups were compared. Results: The mean age of the population was 69.6 +/- 6.3 years and 26.1% of patients were female. There were no statistically significant differences between the two groups in terms of height, weight, gender distribution, comorbidities, preoperative medication, left ventricular function and left atrium diameter. Interventricular septum (IVS) in the non-converted group was significantly thicker compared to the converted group: 14.0 +/- 1.00 vs. 10.40 +/- 2.59 mm (p = 0.036). While 14 patients (60.9%) were successfully converted into stable sinus rhythm by pharmacological treatment with vernakalant and flecainide, 9 patients (39.1%, non-converted group) remained in AF. However, seven of them could be converted after additional EC. Conclusion: The combination of vernakalant and flecainide improves the conversion rate into a stable sinus rhythm in postcardiotomy patients with new onset AF compared to single drug therapy. Furthermore it might be an excellent precondition for successful EC in patients who are not converted after using both antiarrhtythmic drugs. Furthermore, left ventricular hypertrophy might be a potential negative predictor of successful pharmacological cardioversion.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED orcid.org/0000-0002-6289-1035 UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Fatullayev, Javid UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Popov, Aron-Frederik UNSPECIFIED orcid.org/0000-0003-4226-3004 UNSPECIFIED Langebartels, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Kimmig, Lucas UNSPECIFIED orcid.org/0000-0001-8297-0278 UNSPECIFIED Rahmanian, Parwis B. UNSPECIFIED orcid.org/0000-0002-3978-9251 UNSPECIFIED Wittwer, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Neef, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-438370
DOI:	10.1186/1749-8090-9-83
Journal or Publication Title:	J. Cardiothorac. Surg.
Volume:	9
Date:	2014
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1749-8090
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PHARMACOLOGICAL CARDIOVERSION; VERNAKALANT HYDROCHLORIDE; INTRAVENOUS FLECAINIDE; ANTIARRHYTHMIC-DRUG; RAPID CONVERSION; BYPASS-SURGERY; MANAGEMENT; MORTALITY; TRIAL; AMIODARONE Multiple languages Cardiac & Cardiovascular Systems; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43837