title: Atrial fibrillation after aortic arch repair requiring deep hypothermic circulatory arrest: incidence, clinical outcome, and clinical predictors.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Critical Care, Hospital of University of Pennsylvania, Philadelphia, PA 19104-4283, USA. yiandoc@hotmail.com
authors.forename: John G T
authors.initials: JG
authors.lastname: Augoustides
authors.forename: Wilson
authors.initials: W
authors.lastname: Szeto
authors.forename: E Andrew
authors.initials: EA
authors.lastname: Ochroch
authors.forename: Doreen
authors.initials: D
authors.lastname: Cowie
authors.forename: Justin
authors.initials: J
authors.lastname: Weiner
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Gambone
authors.forename: Dawn
authors.initials: D
authors.lastname: Pinchasik
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Bavaria
mesh_terms: 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