الفهرس 
Post-operative atrial fibrillation after cardiac surgeryOnly 14 pages are availabe for public view
 |  | from | 118 |  |  |
| | | from | 118 | | |
Abstract
One of the most frequent complications after cardiac surgery is atrial fibrillation. Atrial fibrillation is defined as any irregular rhythm wirh fluctuating baseline and no definite P wave lasting ≥ 30 s during the postoperative period and required either pharmacologic or electrical cardioversion. It is the most common dysrrhymia in this setting leading to increased cardiovascular morbidity and mortality especially from thromboembolic events. It usually occurs in the immediate postoperative period leading to increased hospital stay and consequently increased finanacial burden. The mechanism of this post-operative atrial fibrillation (POAF) may be attributed to `atrial fibrosis and remodeling together with other perioperative factors such as atrial injury, inflammation, and electrolyte imbalance. Unfortunately, it has been reported that patients who develop these complications have increased late mortality up to four years after surgery. Multiple risk factors for post-operative atrial fibrillation have been identified. However, there is no clear standard for predicting or preventing POAF. Left atrial size and left atrial maximum volume (LAVmax) have been identified as riskfactors for the development of POAF, but the findings have been inconsistent. Patients with high risk for post-operative atrial fibrillation can benefit from prophylactic therapy or even strict post-operative monitoring. Left atrial mechanical function rather than left atrial volume determined by echocardiographic indices have been found to be a stronger risk factor for POAF. In this study we echographically assess the left atrial function determined by left atrial total emptying fraction (TEF) for patients undergoing open cardiac surgeries trying to know its relationship with postoperative atrial fibrillation. Predicting high risk patients for POAF by certain clinical and pre-operative echocardiographic characteristics will help applying prophylactic therapy to those patients. Our study was a prospective study that was carried out in cardiovascular surgery department of Menofia university and El Mahalla cardiac center. Patients postoperatively were allocated to either group 1 or group 2. group 1: patients who developed atrial fibrillation post operatively during their hospital stay. group 2: patients who did not develop atrial fibrillation post operatively. The results of our present study can be summarized as follows: The current study showed that there were no statistically significant differences between group I and group II regarding age. In our study female were (35.7%) and the male were (64.3%) among the patients who developed atrial fibrillation post operatively. In our study, there were no statistically significant differences between group I and group II regarding Diabetes, Hypertension, Smoking and Hyperlipidemia. This study showed that there were no statistically significant differences between group I and group II regarding Indication of surgery, Degree of mitral regurgitation and Degree of tricuspid regurgitation. Our study showed that, there were no statistically significant difference between group I and group II regarding Preoperative & Post-operative serum K (mEq/L), creatinine (mg/dL), TLC (*1000/µL) and Hb (g/dL). The current study showed that there was a highly significant difference between group I and group II regarding LA length (cm), LAV maxI (mL/m2) and LAV minI (mL/m2). There were no statistically significant differences between group I and group II regarding LV mass index (g/m2). Our study showed that there were highly significant differences between group I and group II regarding Hospital stay (days). The present study revealed that there was a highly significant difference between group I and group II regarding LATEF (%) and LATEF. The current study revealed that, there were no statistically significant difference between group I and group II regarding Mitral E′ velocity (cm/s), and there was highly significant difference among group I than group II regarding E velocity and Mitral E/E′. The current study revealed that there were no statistically significant difference between group I and group II regarding A velocity (cm/s), E/A ratio, Mitral A′ velocity (cm/s) and Mitral S velocity (cm/s).