Atrial fibrillation after aortic arch repair requiring deep hypothermic circulatory arrest: incidence, clinical outcome, and clinical predictors.
OBJECTIVE
To delineate the incidence, outcome impact, and clinical predictors of atrial fibrillation (AF) after adult aortic arch repair requiring deep hypothermic circulatory arrest (AAR-DHCA) AIMS: To determine the incidence of AF after AAR-DHCA, to determine whether AF after AAR-DHCA affects mortality or stay in the intensive care unit (ICU), to determine multivariate predictors for AF after AAR-DHCA, and to determine whether aprotinin protects against AF after AAR-DHCA.


METHODS
Retrospective and observational.


METHODS
Single large university hospital.


METHODS
All adults undergoing AAR-DHCA in 2000 and 2001.


RESULTS
The cohort size was 144. Antifibrinolytic exposure was 100%, aprotinin 66% and aminocaproic acid 34%. The incidence of AF was 34.0%. AF was not significantly associated with increased mortality or prolonged ICU stay. Advanced age was a multivariate risk factor for AF. Lower temperature nadir during DHCA was protective against postoperative AF. Aprotinin had no demonstrable effect on AF after AAR-DHCA.


CONCLUSIONS
AF after AAR-DHCA is common but does not independently increase mortality or ICU stay. The risk of AF after AAR-DHCA increases with age but decreases with the degree of hypothermia during DHCA. Aprotinin does not appear to affect the risk of AF after AAR-DHCA.
Augoustides
John G T
JG
Department of Anesthesiology and Critical Care, Hospital of University of Pennsylvania, Philadelphia, PA 19104-4283, USA. yiandoc@hotmail.com
Szeto
Wilson
W
Ochroch
E Andrew
EA
Cowie
Doreen
D
Weiner
Justin
J
Gambone
Andrew J
AJ
Pinchasik
Dawn
D
Bavaria
Joseph E
JE
D000328:Adult; D000367:Age Factors; D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D001281:Atrial Fibrillation / Q000209:etiology* / Q000517:prevention & control; D002315:Cardiopulmonary Bypass; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors