Thoracic epidural anesthesia does not influence the occurrence of postoperative sustained atrial fibrillation

Jideus, LenaUppsala universitet,Institutionen för kirurgiska vetenskaper,Departments of Surgical Sciences, Thoracic and Cardiovascular Surgery, University Hospital, Uppsala (author)

NR 20140805
Background. To evaluate whether thoracic epidural anesthesia (TEA) can reduce the incidence of atrial fibrillation (AF) after coronary artery bypass grafting (CABG).Methods. Forty-one patients undergoing CABG were treated with TEA intraoperatively and postoperatively. Another 80 patients served as the control group. The sympathetic and parasympathetic activities were evaluated by analysis of neuropeptides, catecholamines and heart rate variability (HRV), preoperatively and postoperatively.Results. Postoperative AF occurred in 31.7% of the TEA-treated patients and in 36.3% of the untreated patients (p = 0.77). TEA significantly suppressed sympathetic activity, as indicated by a less pronounced increase of norepinephrine and epinephrine (p = 0.03, p = 0.02) and a significant decrease of neuropeptide Y (p = 0.01) postoperatively in TEA-treated patients compared to untreated patients. The HRV variable expressing sympathetic activity was significantly lower and the postoperative increase in heart rate was significantly less in the TEA group than in the control group after surgery (p = 0.01, p < 0.001). Among patients developing AF, the maximal number of supraventricular premature beats per minute increased significantly in untreated patients postoperatively but remained unchanged in TEA-treated patients (p = 0.004 versus p = 0.86).Conclusions. TEA has no effect on the incidence of postoperative sustained AF, despite a significant reduction in sympathetic activity.

Joachimsson, Per-OlofDepartment of Cardiothoracic Anesthesiology, Medical Sciences, Clinical Chemistry and Cardiology, University Hospital, Uppsala(Swepub:uu)pejoa103 (author)
Stridsberg, MatsUppsala universitet,Institutionen för medicinska vetenskaper,Department of Cardiothoracic Anesthesiology, Medical Sciences, Clinical Chemistry and Cardiology, University Hospital, Uppsala(Swepub:uu)matsstri (author)
Ericson, MatsMittuniversitetet,KTH,Ergonomi,Institutionen för hälsovetenskap (-2013)(Swepub:miun)exmatser (author)
Tyden, HansUppsala universitet,Institutionen för medicinska vetenskaper,Department of Cardiothoracic Anesthesiology, Medical Sciences, Clinical Chemistry and Cardiology, University Hospital, Uppsala(Swepub:uu)hatyd173 (author)
Nilsson, LeifUppsala universitet,Institutionen för kirurgiska vetenskaper,Departments of Surgical Sciences, Thoracic and Cardiovascular Surgery, University Hospital, Uppsala (author)
Blomström, PerMittuniversitetet,Institutionen för hälsovetenskap (-2013)(Swepub:miun)experblo (author)
Blomstrom-Lundqvist, CarinMittuniversitetet,Institutionen för hälsovetenskap (-2013)(Swepub:miun)excarblo (author)
Uppsala universitetInstitutionen för kirurgiska vetenskaper (creator_code:org_t)

By the author/editor: Jideus, Lena; Joachimsson, Per ...; Stridsberg, Mats; Ericson, Mats; Tyden, Hans; Nilsson, Leif; show more...; Blomström, Per; Blomstrom-Lundqv ...; show less...

By the university: Uppsala University; Royal Institute of Technology; Mid Sweden University

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