Fibrilación auricular en el postoperatorio inmediato de la cirugía de revascularización miocárdica

Kirenia Espronceda Sánchez, Juliette Massip Nicot, Genoveva Elva Henry Vera

Resumen

Introducción: Las alteraciones del ritmo constituyen las complicaciones más frecuentes en el postoperatorio de la cirugía cardiaca y entre ellas la más común es la fibrilación auricular de nueva aparición. Objetivo: Describir el comportamiento de la Fibrilación auricular en el postoperatorio de la cirugía coronaria teniendo como referencia un grupo control. Método: Estudio transversal, descriptivo, de un universo constituido por 100 pacientes de ambos sexos intervenidos por enfermedad arterial coronaria desde enero hasta diciembre del año 2017 en el Instituto de Cardiología y Cirugía Cardiovascular. Se crearon dos categorías: con y sin fibrilación auricular en el postoperatorio inmediato. Resultados: En los dos grupos predominó el sexo masculino. Encontramos valor de p<0,05 en la enfermedad arterial coronaria de dos o más vasos para su comparación. Ninguna de las variables dependientes del acto quirúrgico ni del postoperatorio inmediato resultaron significativas en su análisis estadístico. En el grupo con FAp igual cantidad de pacientes fue intervenido con circulación extracorpórea y con el corazón latiendo. En el caso de las complicaciones en el postoperatorio inmediato evidenciaron diferencias estadísticas significativas al analizar trastornos electrolíticos como la Hipopotasemia así como con la presencia de isquemia miocárdica perioperatoria Conclusiones: La Fibrilación auricular requiere un cuidadoso seguimiento a largo plazo con mayor número de pacientes. La información obtenida en este estudio nos permitió mejorar la caracterización de los pacientes sometidos a revascularización miocárdica quirúrgica en nuestro centro sin extrapolar resultados foráneos.

Referencias

Hamidi SH, Faghanzadeh-Ganji G, Baghaeian A, Bijani A, Pourkia R. Effect of variability of central venous pressure values to prevent atrial fibrillation after coronary bypass grafting. Caspian J Intern Med [Internet]. 2021 Apr [Cited 2022 Mar 3];12(3):299-306. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223041/pdf/cjim-12-299.pdf

Engin M, Ozsin KK, Savran M, Guvenc O, Yavuz S, Fatih Ozyazicioglu AF. Visceral adiposity index and prognostic nutritional index in predicting atrial fibrillation after on-pump coronary artery bypass operations: a prospective study. Braz J Cardiovasc Surg [Internet]. 2021 Aug 6 [Cited 2022 Mar 3];36(4):522-9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522311/pdf/rbccv-36-04-0522.pdf

Cohn SL. Cohn. Update in perioperative cardiac medicine 2021. Clev Clin J Med [Internet]. 2021 Apr 1 [Cited 2022 Feb 19];88(4):216-21. Available from: https://www.ccjm.org/content/88/4/216

Liu S, Li Z, Liu Z, Hu Z, Zheng G. Blood transfusion and risk of atrial fibrillation after coronary artery bypass graft surgery. A meta-analysis of cohort studies. Medicine (Baltimore) [Internet]. 2018 Mar [Cited 2021 Dec 28];97(10):1-6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882418/pdf/medi-97-e9700.pdf

Fan K, Chen L, Liu F, Ding X, Yan P, Gao M, et al. Predicting new-onset postoperative atrial fibrillation following isolated coronary artery bypass grafting: development and validation of a novel nomogram. Int J Gen Med [Internet]. 2022 Jan 26[Cited 2022 Mar 29];15:937-48. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801512/pdf/ijgm-15-937.pdf

Qureshi M, Ahmed A, Massie V, Marshall E, Harky A. Determinants of atrial fibrillation after cardiac surgery. Rev Cardiovasc Med [Internet]. 2021 Jun 30 [Cited 2022 Feb 19];22(2):329-41. Available from: https://www.imrpress.com/journal/RCM/22/2/10.31083/j.rcm2202040/pdf

Lohchab SS, Kumar A. Post-operative atrial fibrillation after off-pump coronary artery bypass grafting. Indian J Thorac Cardiovasc Surg [Internet]. 2020 Jan-Feb [Cited 2020 Dec 30];36(1):4-5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525842/pdf/12055_2019_Article_849.pdf

Rachwalik M, Obremska M, Zyśko D, Matusiewicz M, Ściborski K, Jasiński M. The concentration of resistin in perivascular adipose tissue after CABG and postoperative atrial fibrillation. BMC Cardiovasc Disord [Internet]. 2019 Dec 16 [Cited 2021 Dec 28];19(1):1-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915954/pdf/12872_2019_Article_1254.pdf

Bening C, Mazalu EA, Yaqub J, Alhussini K, Glanowski M, Kottmann T. Atrial contractility and fibrotic biomarkers are associated with atrial fibrillation after elective coronary artery bypass grafting. J Thorac Cardiovasc Surg [Internet]. 2020 [Cited 2021 Dec 28];159(2):515-23. Available from: https://www.jtcvs.org/action/showPdf?pii=S0022-5223%2819%2930515-X

Kertai MD, Mosley JD, He J, Ramakrishnan A, Abdelmalak MJ, Hong Y, Shoemaker MB. Predictive accuracy of a polygenic risk score for postoperative atrial fibrillation after cardiac surgery. Circ Genom Precis Med [Internet]. 2021 Apr [Cited 2022 Feb 19];14(2). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058298/pdf/hcg-14-e003269.pdf

Mauro MD, Calafiore AM, Di Franco A, Nicolini F, Formica F, Scrofani R, et al. Association between cardioplegia and postoperative atrial fibrillation in coronary surgery. Int J Cardiol [Internet]. 2021 Feb 1 [Cited 2022 Feb 19];324:38-43. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874574/pdf/nihms-1663249.pdf

Nomani H, Mohammadpour AH, Reiner Ž, Jamialahmadi T, Sahebkar A. Statin therapy in post-operative atrial fibrillation: focus on the anti-inflammatory effects. J Cardiovasc Dev Dis [Internet]. 2021 Feb 26 [Cited 2022 Feb 19];8(24):1-13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996747/pdf/jcdd-08-00024.pdf

Smukowska-Gorynia A, Perek B, Jemielity M, Olasińska-Wiśniewska A, Marcinkowska J, Stefaniak S. Neopterin as a predictive biomarker of postoperative atrial fibrillation following coronary artery bypass grafting. Kardiol Pol [Internet]. 2022 Jun 14 [Cited 2022 Jul 27];1-26. Available from: https://journals.viamedica.pl/kardiologia_polska/article/download/KP.a2022.0143/67035

Osmanovic E, Ostojic M, Avdic S, Djedovic S, Delic A, Kadric N, et al. Pharmacological prophylaxis of atrial fibrillation after surgical myocardial revascularization. Med Arch [Internet]. 2019 Feb [Cited 2021 Dec 28];73(1):19-22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445624/pdf/medarch-73-19.pdf

Selcuk M, Cinar T, Saylik F, Dogan S, Selcuk I, Orhan AL. Predictive value of systemic immune inflammation index for postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting. Medeni Med J [Internet]. 2021 Dec 19 [Cited 2022 Feb 19];36(4):318-24. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8694166/pdf/medj-36-318.pdf

Rajput HAS, Khan F, Zargar UQ, Iqbal F, Shamim K, Wahab A, et al. Association of atrial fibrillation with patient characteristics in postoperative coronary artery bypass grafting surgery. Cureus [Internet]. 2021 Nov 22 [Cited 2022 Feb 19]; 13(11):1-4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8693829/pdf/cureus-0013-00000019800.pdf

Malhotra P, Pande S, Mahindru S, Thukral A, Kotwal AS, Gupta RP, et al. Postoperative atrial fibrillation in coronary artery bypass grafting herald poor outcome. Ann Card Anaesth [Internet]. 2021 Oct-Dec 18 [Cited 2022 Mar 29];24(4):464-9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8617379/pdf/ACA-24-464.pdf

Ozben B, Akaslan D, Sunbul M, Filinte D, Ak K, Sari I, et al. Postoperative atrial fibrillation after coronary artery bypass grafting surgery: a two-dimensional speckle tracking echocardiography study. Heart Lung Circ [Internet]. 2016 Oct [Cited 2021 Dec 28];25(10):993-9.

Konstantino Y, Zelnik Yovel D, Friger MD, Sahar G, Knyazer B, Amit G. Postoperative atrial fibrillation following coronary artery bypass graft surgery predicts long-term atrial fibrillation and stroke. Isr Med Assoc J [Internet]. 2016 Dec [Cited 2021 Dec 28];18(12):744-8.

Taha A, Nielsen SJ, Bergfeldt L, Ahlsson A, Friberg L, Bjorck S, et al. New-onset atrial fibrillation after coronary artery bypass grafting and long-term outcome: A population-based Nationwide study from the SWEDEHEART Registry. J Am Heart Assoc [Internet]. 2020 [Cited 2022 Feb 19];10(1):1-14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955471/pdf/JAH3-10-e017966.pdf

Lewicki Ł, Sieber t J, Rogowski J. Atrial fibrillation following off-pump versus on-pump coronary artery bypass grafting: Incidence and risk factors. Cardiol J [Internet]. 2016 [Cited 2021 Dec 28];23(5):518-23. Available from: https://journals.viamedica.pl/cardiology_journal/article/download/CJ.a2016.0066/35951

Vargas C, Vargas D, Neira V, Binder R, Backhouse C, Bobadilla B, et al. Bajos niveles de colesterol HDL es un predictor de mortalidad y de fibrilación auricular postoperatoria posterior a la cirugía de revascularización miocárdica. Rev Chil Cardiol [Internet]. 2015 [Citado 2021 Dic 30];34(2):106-12. Disponible en: https://www.scielo.cl/pdf/rchcardiol/v34n2/art04.pdf

Irigoin J, Zócalo Y, Cortellezzi Z, González V, Reyes Caorsi W, Varela G, et al. Incidencia de la fibrilación auricular poscirugía de revascularización miocárdica: asociación con uso de circulación extracorpórea. Rev Urug Cardiol [Internet]. 2007 Aug [Citado 2021 Dic 30];22(2):123-9. Disponible en: http://www.scielo.edu.uy/pdf/ruc/v22n2/v22n2a07.pdf

Gorczyca I, Michta K, Pietrzyk E, Wożakowska-Kapłon B. Predictors of post-operative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting. Kardiol Pol [Internet]. 2018 Oct 9 [Cited 2022 Feb 19];76(1):195-201. Available from: https://journals.viamedica.pl/kardiologia_polska/article/download/KP.a2017.0203/58445

Seo EJ, Hong J, Lee HJ, Son YJ. Perioperative risk factors for new‑onset postoperative atrial fibrillation after coronary artery bypass grafting: a systematic review. BMC Cardiovasc Disord [Internet]. 2021 Sep 3 [Cited 2022 Feb 19];21(1):3-11. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8414730/pdf/12872_2021_Article_2224.pdf

Peker Y, Holtstrand-Hjälm H, Celik Y, Glantz H, Thunström E. Postoperative atrial fibrillation in adults with obstructive sleep apnea undergoing coronary artery bypass grafting in the RICCADSA cohort. J Clin Med [Internet]. 2022 Apr 27 [Cited 2022 Jul 27];11(9):2-11. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103536/pdf/jcm-11-02459.pdf

Thorén E, Hellgren L, Ståhle E. High incidence of atrial fibrillation after coronary surgery. Interact Cardiovasc Thorac Surg [Internet]. 2016 Feb [Cited 2021 Dec 28];22(2):176-80. Available from: https://academic.oup.com/icvts/article-pdf/22/2/176/8243244/ivv326.pdf

Xu S, Zhang J, Xu YL, Wu HB, Xue XD, Wang HS. Relationship between angiotensin converting enzyme, apelin, and new-onset atrial fibrillation after off-pump coronary artery bypass grafting. Biomed Res Int [Internet]. 2017 Feb 12 [Cited 2021 Dec 28];2017:1-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337318/pdf/BMRI2017-7951793.pdf

Burrage PS, Low YH, Campbell NG, O’Brien B. New-onset atrial fibrillation in adult patients after cardiac surgery. Curr Anesthesiol Rep. [Internet]. 2019 Jun [Cited 2021 Dec 30];9(2):174-93. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837869/pdf/EMS84766.pdf

Phan K, Ha HS, Phan S, Medi C, Thomas SP, Yan TD. New-onset atrial fibrillation following coronary bypass surgery predicts long-term mortality: a systematic review and meta-analysis. Eur J Cardiothorac Surg [Internet]. 2015 Dec[Cited 2021 Dec 28];48:817-24. Available from: https://academic.oup.com/ejcts/article-pdf/48/6/817/17464089/ezu551.pdf

Bockeria OL, Shvartz VA, Akhobekov AA, Kiselev AR, Prokhorov MD, Golukhova EZ, et al. Statin therapy in the primary prevention of early atrial fibrillation after coronary artery bypass grafting. Indian Heart J [Internet]. 2016 Nov-Dec [Cited 2021 Dec 28];68(6):792-7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5143807/pdf/main.pdf

Folla CO, Melo CC, Silva RC. Predictive factors of atrial fibrillation after coronary artery bypass grafting. Einstein (Sao Paulo) [Internet]. 2016 Oct-Dec [Cited 2021 Dec 28];14(4):480-5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221373/pdf/1679-4508-eins-14-04-0480.pdf

Lescano A, Arazi HC. Fibrilación auricular en el perioperatorio de cirugía Cardiovascular. Revista argentina de cirugía cardiovascular [Internet]. 2019 May- Ago [citado 2020 Dic 30];17(2);58-68. Disponible en: https://www.google.com/url?sa=t&source=web&rct=j&url=https://caccv.org.ar/raccv-es-2019/Art_58-68_articulo_de_revision.pdf&ved=2ahUKEwjOyPrOp-P5AhVWTDABHUx7BJwQFnoECAoQAQ&usg=AOvVaw1AFXp4TSYKOFGqzJAn081R

Premaratne S, Premaratne ID, Fernando ND, Williams L, Hasaniya NW. Atrial fibrillation and flutter following coronary artery bypass graft surgery: A retrospective study and review. JRSM Cardiovasc Dis [Internet]. 2016 Apr 9 [Cited 2020 Dec 30];5:1-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834471/pdf/10.1177_2048004016634149.pdf

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