A new system for right atrial cooling.
OBJECTIVE
Controlled hypothermia of the right atrium has been shown to reduce postoperative atrial fibrillation after on-pump coronary artery bypass grafting. A device has been developed that couples right atrial and nodal cooling with modified dual-stage venous drainage by circulating cold sterile saline through an intracavity, shape-memory balloon.


METHODS
The atrial cooling device was used in 41 patients undergoing elective coronary artery bypass grafting. Systemic temperatures were held at 36 degrees C, and temperatures of atrial structures were reduced to about 19 degrees to 20 degrees C at 30 minutes.


RESULTS
Electrical activity was effectively suppressed during cross-clamp by controlled cooling of the right atrium. Hemodilution was reduced by right atrial isolation and collection of crystalloid cardioplegia. Cardiac electrical activity returned without sustained arrhythmias in all patients. Postoperative atrial fibrillation developed in only 3 of the 38 patients.


CONCLUSIONS
The results indicate that local atrial cooling may contribute to protection of the right atrium, subsequently reducing the incidence of transient postoperative atrial fibrillation.
Huybregts
Marinus A J M
MA
Department of Cardiac Surgery, University Hospital Vrije Universiteit, Amsterdam, The Netherlands. majm.huybregts@vumc.nl
de Vroege
Roel
R
van Oeveren
Wim
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000517:prevention & control*; D002314:Cardioplegic Solutions / Q000627:therapeutic use; D015331:Cohort Studies; D003080:Cold Temperature; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced / Q000295:instrumentation* / Q000379:methods; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
D002314:Cardioplegic Solutions