Insights into new-onset atrial fibrillation following open heart surgery and implications for type II atrial flutter

Shervin A. Sadrpour, Deepa Srinivasan, Ashish A. Bhimani, Seungyup Lee, Kyungmoo Ryu, Ivan Cakulev, Celeen M. Khrestian, Alan H. Markowitz, Albert L. Waldo, Jayakumar Sahadevan

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Aims Postoperative atrial fibrillation (POAF), new-onset AF after open heart surgery (OHS), is thought to be related to pericarditis. Based on AF studies in the canine sterile pericarditis model, we hypothesized that POAF in patients after OHS may be associated with a rapid, regular rhythm in the left atrium (LA), suggestive of an LA driver maintaining AF. The aim of this study was to test the hypothesis that in patients with POAF, atrial electrograms (AEGs) recorded from at least one of the two carefully selected LA sites would manifest a rapid, regular rhythm with AEGs of short cycle length (CL) and constant morphology, but a selected right atrial (RA) site would manifest AEGs with irregular CLs and variable morphology. Methods and results In 44 patients undergoing OHS, AEGs recorded from the epicardial surface of the RA, the LA portion of Bachmann's bundle, and the posterior LA during sustained AF were analysed for regularity of CL and morphology. Sustained AF occurred in 15 of 44 patients. Atrial electrograms were recorded in 11 of 15 patients; 8 of 11 had rapid, regular activation with constant morphology recorded from at least one LA site; no regular AEG sites were present in 3 of 11 patients. Conclusions Atrial electrograms recorded during sustained POAF frequently demonstrated rapid, regular activation in at least one LA site, consistent with a driver maintaining AF.

Original languageEnglish (US)
Pages (from-to)1834-1839
Number of pages6
JournalEuropace
Volume17
Issue number12
DOIs
StatePublished - Nov 10 2015
Externally publishedYes

    Fingerprint

Keywords

  • Atrial arrhythmias
  • Atrial electrograms
  • Atrial fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Sadrpour, S. A., Srinivasan, D., Bhimani, A. A., Lee, S., Ryu, K., Cakulev, I., Khrestian, C. M., Markowitz, A. H., Waldo, A. L., & Sahadevan, J. (2015). Insights into new-onset atrial fibrillation following open heart surgery and implications for type II atrial flutter. Europace, 17(12), 1834-1839. https://doi.org/10.1093/europace/euv019