Skip to main content
SpringerLink
Log in

Arrhythmias and Conduction Disturbances After Coronary Artery Bypass Graft Surgery

  • Chapter
  • First Online:
Coronary Graft Failure

  • 1027 Accesses

Abstract

Coronary bypass surgery is associated with complications that can occur in the perioperative and postoperative moments. One domain of those it is represented by supraventricular and ventricular arrhythmias and conduction disturbances after coronary artery bypass graft surgery. The most common arrhythmia that occurs in the postoperative stage, especially in older patients, is represented by atrial fibrillation. This particular arrhythmia is associated with cardiac insufficiency phenomenon, hemodynamic impact, and a higher rate of stroke and postoperative mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Fryar CD, Chen T-C, Li X. Prevalence of uncontrolled risk factors for cardiovascular disease: United States, 1999–2010. CDC National Center for Health Statistics (NCHS) data brief 2012. http://www.cdc.gov/nchs/data/databriefs/db103.htm

  2. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Pires LA, Wagshal AB, Lancey R, Huang SK. Arrhythmias and conduction disturbances after coronary artery bypass graft surgery: epidemiology, management, and prognosis. Am Heart J. 1995;129(4):799–808.

    Article  CAS  PubMed  Google Scholar 

  4. Aranki SF, Shaw DP, Adams DH, Rizzo RJ, Couper GS, VanderVliet M, et al. Predictors of atrial fibrillation after coronary artery surgery: current trends and impact on hospital resources. Circulation. 1996;94(3):390–7.

    Article  CAS  PubMed  Google Scholar 

  5. Echahidi N, Pibarot P, O'Hara G, Mathieu P. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery. J Am Coll Cardiol. 2008;51(8):793–801.

    Article  CAS  PubMed  Google Scholar 

  6. Almassi GH, Schowalter T, Nicolosi AC, Aggarwal A, Moritz TE, Henderson WG, et al. Atrial fibrillation after cardiac surgery: a major morbid event? Ann Surg. 1997;226(4):501–11. discussion 511–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Mathew JP, Fontes ML, Tudor IC, Ramsay J, Duke P, Mazer CD, Investigators of the Ischemia Research and Education Foundation, Multicenter Study of Perioperative Ischemia Research Group, et al. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA. 2004;291(14):1720–9.

    Article  CAS  PubMed  Google Scholar 

  8. Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ, et al. Pathophysiology and prevention of atrial fibrillation. Circulation. 2001;103(5):769–77.

    Article  CAS  PubMed  Google Scholar 

  9. Creswell LL, Schuessler RB, Rosenbloom M, Cox JL. Hazards of post-operative atrial arrhythmias. Ann Thorac Surg. 1993;56(3):539–49.

    Article  CAS  PubMed  Google Scholar 

  10. Hogue Jr CW, Domitrovich PP, Stein PK, Despotis GD, Re L, Schuessler RB, et al. RR interval dynamics before atrial fibrillation in patients after coronary artery bypass graft surgery. Circulation. 1998;98(5):429–34.

    Article  PubMed  Google Scholar 

  11. Maisel WH, Rawn JD, Stevenson WG. Atrial fibrillation after cardiac surgery. Ann Intern Med. 2001;135(12):1061–73.

    Article  CAS  PubMed  Google Scholar 

  12. Ishii Y, Schuessler RB, Gaynor SL, Yamada K, Fu AS, Boineau JP, et al. Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial conduction and atrial fibrillation. Circulation. 2005;111(22):2881–8. Epub 2005 May 31.

    Article  CAS  PubMed  Google Scholar 

  13. Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, American College of Cardiology/American Heart Association Task Force on Practice Guidelines, European Society of Cardiology Committee for Practice Guidelines, European Heart Rhythm Association; Heart Rhythm Society, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114(7):e257–354.

    Article  PubMed  Google Scholar 

  14. Crystal E, Garfinkle MS, Connolly SS, Ginger TT, Sleik K, Yusuf SS. Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery. Cochrane Database Syst Rev. 2004;4:CD003611.

    PubMed  Google Scholar 

  15. Burgess DC, Kilborn MJ, Keech AC. Interventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis. Eur Heart J. 2006;27(23):2846–57.

    Article  PubMed  Google Scholar 

  16. Nyström U, Edvardsson N, Berggren H, Pizzarelli GP, Rådegran K. Oral sotalol reduces the incidence of atrial fibrillation after coronary artery bypass surgery. Thorac Cardiovasc Surg. 1993;41(1):34–7.

    Article  PubMed  Google Scholar 

  17. Guarnieri T, Nolan S, Gottlieb SO, Dudek A, Lowry DR. Intravenous amiodarone for the prevention of atrial fibrillation after open heart surgery: the Amiodarone Reduction in Coronary Heart (ARCH) trial. J Am Coll Cardiol. 1999;34(2):343–7.

    Article  CAS  PubMed  Google Scholar 

  18. Patel AA, White CM, Gillespie EL, Kluger J, Coleman CI. Safety of amiodarone in the prevention of post-operative atrial fibrillation: a meta-analysis. Am J Health Syst Pharm. 2006;63(9):829–37.

    Article  CAS  PubMed  Google Scholar 

  19. Podrid PJ. Prevention of post-operative atrial fibrillation: what is the best approach? J Am Coll Cardiol. 1999;34(2):340–2.

    Article  CAS  PubMed  Google Scholar 

  20. Wijeysundera DN, Beattie WS, Rao V, Karski J. Calcium antagonists reduce cardiovascular complications after cardiac surgery: a meta-analysis. J Am Coll Cardiol. 2003;41(9):1496–505.

    Article  CAS  PubMed  Google Scholar 

  21. Satur CM. Magnesium and cardiac surgery. Ann R Coll Surg Engl. 1997;79(5):349–54.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Vyvyan HA, Mayne PN, Cutfield GR. Magnesium flux and cardiac surgery: a study of the relationship between magnesium exchange, serum magnesium levels and post-operative arrhythmias. Anaesthesia. 1994;49(3):245–9.

    Article  CAS  PubMed  Google Scholar 

  23. Marín F, Pascual DA, Roldán V, Arribas JM, Ahumada M, Tornel PL, et al. Statins and postoperative risk of atrial fibrillation following coronary artery bypass grafting. Am J Cardiol. 2006;97(1):55–60. Epub 2005 Nov 7.

    Article  PubMed  Google Scholar 

  24. Patti G, Chello M, Candura D, Pasceri V, D’Ambrosio A, Covino E, et al. Randomized trial of atorvastatin for reduction of postoperative atrial fibrillation in patients undergoing cardiac surgery: results of the ARMYDA-3 (Atorvastatin for Reduction of MYocardial Dysrhythmia After cardiac surgery) study. Circulation. 2006;114(14):1455–61. Epub 2006 Sep 25.

    Article  CAS  PubMed  Google Scholar 

  25. Jahangiri A, Leifert WR, Patten GS, McMurchie EJ. Termination of asynchronous contractile activity in rat atrial myocytes by N-3 polyunsaturated fatty acids. Mol Cell Biochem. 2000;206(1–2):33–41.

    Article  CAS  PubMed  Google Scholar 

  26. Calò L, Bianconi L, Colivicchi F, Lamberti F, Loricchio ML, de Ruvo E, et al. N-3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial. J Am Coll Cardiol. 2005;45(10):1723–8.

    Article  PubMed  Google Scholar 

  27. Cheruku KK, Ghani A, Ahmad F, Pappas P, Silverman PR, Zelinger A, et al. Efficacy of nonsteroidal anti-inflammatory medications for prevention of atrial fibrillation following coronary artery bypass graft surgery. Prev Cardiol. 2004;7(1):13–8.

    Article  CAS  PubMed  Google Scholar 

  28. Archbold RA, Schilling RJ. Atrial pacing for the prevention of atrial fibrillation after coronary artery bypass graft surgery: a review of the literature. Heart. 2004;90(2):129–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Satoh T, Zipes DP. Unequal atrial stretch in dogs increases dispersion of refractoriness conducive to developing atrial fibrillation. J Cardiovasc Electrophysiol. 1996;7(9):833–42.

    Article  CAS  PubMed  Google Scholar 

  30. Gillis AM, Wyse DG, Connolly SJ, Dubuc M, Philippon F, Yee R, et al. Atrial pacing periablation for prevention of paroxysmal atrial fibrillation. Circulation. 1999;99(19):2553–8.

    Article  CAS  PubMed  Google Scholar 

  31. Prakash A, Delfaut P, Krol RB, Saksena S. Regional right and left atrial activation patterns during single- and dual-site atrial pacing in patients with atrial fibrillation. Am J Cardiol. 1998;82(10):1197–204.

    Article  CAS  PubMed  Google Scholar 

  32. Hogue Jr CW, Murphy SF, Schechtman KB, Dávila-Román VG. Risk factors for early or delayed stroke after cardiac surgery. Circulation. 1999;100(6):642–7.

    Article  PubMed  Google Scholar 

  33. Huikuri HV, Yli-Mäyry S, Korhonen UR, Airaksinen KE, Ikäheimo MJ, Linnaluoto MK, et al. Prevalence and prognostic significance of complex ventricular arrhythmias after coronary arterial bypass graft surgery. Int J Cardiol. 1990;27(3):333–9.

    Article  CAS  PubMed  Google Scholar 

  34. Topol EJ, Lerman BB, Baughman KL, Platia EV, Griffith LS. De novo refractory ventricular tachyarrhythmias after coronary revascularization. Am J Cardiol. 1986;57(1):57–9.

    Article  CAS  PubMed  Google Scholar 

  35. Sapin PM, Woelfel AK, Foster JR. Unexpected ventricular tachyarrhythmias soon after cardiac surgery. Am J Cardiol. 1991;68(10):1099–100.

    Article  CAS  PubMed  Google Scholar 

  36. Pinto RP, Romerill DB, Nasser WK, Schier JJ, Surawicz B. Prognosis of patients with frequent premature ventricular complexes and nonsustained ventricular tachycardia after coronary artery bypass graft surgery. Clin Cardiol. 1996;19(4):321–4.

    Article  CAS  PubMed  Google Scholar 

  37. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med. 1996;335(26):1933–40.

    Article  CAS  PubMed  Google Scholar 

  38. Fogel RI, Prystowsky EN. Management of malignant ventricular arrhythmias and cardiac arrest. Crit Care Med. 2000;28(10 Suppl):N165–9.

    Article  CAS  PubMed  Google Scholar 

  39. Rousou JA, Engelman RM, Flack 3rd JE, Deaton DW, Owen SG. Emergency cardiopulmonary bypass in the cardiac surgical unit can be a lifesaving measure in postoperative cardiac arrest. Circulation. 1994;90(5 Pt 2):II280–4.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Army’s Center for Cardiovascular Disease, Bucharest, Romania

    Liviu Chiriac MD, FESC

  2. Department of Cardiology, Army’s Emergency Cardiovascular Center “Acad Vasile Cândea”, Bucharest, Romania

    Razvan Rosulescu PhD, MD

Authors
  1. Liviu Chiriac MD, FESC
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Razvan Rosulescu PhD, MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Liviu Chiriac MD, FESC .

Editor information

Editors and Affiliations

  1. Cardiology, Army's Center for Cardiovascular Di, Bucharest, Romania

    Ion C. Ţintoiu

  2. Department of Surgery, Chinese University of Hong Kong, Sha Tin, Hong Kong

    Malcolm John Underwood

  3. University Fribourg, Hospital HFR Fribourg, Fribourg, Fribourg, Switzerland

    Stephane Pierre Cook

  4. Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan

    Hironori Kitabata

  5. University Medical Center, Texas Tech Univ. Health Science Center, EL PASO, Texas, USA

    Aamer Abbas

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Chiriac, L., Rosulescu, R. (2016). Arrhythmias and Conduction Disturbances After Coronary Artery Bypass Graft Surgery. In: Ţintoiu, I., Underwood, M., Cook, S., Kitabata, H., Abbas, A. (eds) Coronary Graft Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-26515-5_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26515-5_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26513-1

  • Online ISBN: 978-3-319-26515-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation