title: Post-operative atrial fibrillation management by selective epicardial vagal fat pad stimulation.
abstract: OBJECTIVE
  Post-operative atrial fibrillation (POAF) is a common complication after cardiac surgery and often leads to poorly tolerated fast ventricular rates. Negative dromotropic drugs are not always effective and may not be well tolerated in heart failure patients. Aim of this study is to verify if high-frequency stimulation of the right inferior fat pad (RIFPS) allows an effective decrease in ventricular rate (VR) during POAF.
  
  
  METHODS
  We enrolled 32 consecutive patients submitted to bypass; during surgery, a temporary heart wire was implanted in a site where RIFPS evoked a functional AV block. During POAF, RIFPS was delivered from the heart wire to decrease VR.
  
  
  RESULTS
  Intra-operative RIFPS evoked complete AV block in 29 patients (91%). Fourteen patients (44%) developed POAF (mean VR 127 +/- 12 bpm). In these patients, RIFPS achieved a 25% reduction of VR and complete AV block with 6.0 +/- 1.9 and 7.5 +/- 1.8 V (duration 0.2 ms, frequency 50 Hz), respectively.
  
  
  CONCLUSIONS
  Epicardial RIFPS represents an effective and feasible technique to decrease VR during POAF.
authors.affiliation: Department of Medicine, Unit of Electrophysiology, Belcolle Hospital, Viterbo, Italy. pietro_rossi2004@yahoo.it
authors.forename: Pietro
authors.initials: P
authors.lastname: Rossi
authors.forename: Stefano
authors.initials: S
authors.lastname: Bianchi
authors.forename: Antonio
authors.initials: A
authors.lastname: Barretta
authors.forename: Alberto
authors.initials: A
authors.lastname: Della Scala
authors.forename: Lilian
authors.initials: L
authors.lastname: Kornet
authors.forename: Ruggero
authors.initials: R
authors.lastname: De Paulis
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bellisario
authors.forename: Vittorio
authors.initials: V
authors.lastname: D'Addio
authors.forename: Herribert
authors.initials: H
authors.lastname: Pavaci
authors.forename: Fabio
authors.initials: F
authors.lastname: Miraldi