title: Surgical feasibility of the injection of fibrin sealant in cardiac fat pads to reduce the incidence of postoperative atrial fibrillation after coronary artery bypass grafting or valve surgery: a pilot study.
abstract: OBJECTIVE
  : Atrial fibrillation (AF) is the most common complication following coronary artery bypass grafting or valve surgery.The autonomic nervous system is an important determinant in the development of AF. We have assessed the role of injection of fibrin sealant (FS) as a method to modify conduction in the fad pads, to mimic temporary denervation and to reduce the incidence of postoperative AF in patients undergoing coronary artery bypass grafting or valve surgery.
  
  
  METHODS
  : Twenty eligible patients who underwent coronary bypass grafting or aortic valve surgery in our Institution were included in this pilot - study.Detection of AF after surgical intervention was based on patient symptomatology and on daily electrocardiograms obtained on all patients. Telemetry was used in all patients for the entire hospitalization period.
  
  
  RESULTS
  : 20% of the studied population (n = 4) developed postoperative AF. At the time of discharge one patient (5%) had persistent AF.Postoperative mortality was 5% (n = 1) and not cardiac related. None of the patients required permanent pacemaker implantation.
  
  
  CONCLUSIONS
  : This first human study of FS injected into the anterior fad pads following low to moderate risk open heart surgery shows, that this procedure is safe and feasible. Moreover, CM -1 injection appears to reduce the need for postoperative intervention and/or treatment of AF by diminishing its incidence.
authors.affiliation: From the *Department of Cardiovascular Surgery, Rhoen Klinikum, Bad Neustadt; and †Department of Cardiology, Coburg General Hospital, Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Chryssagis
authors.forename: Stefan
authors.initials: S
authors.lastname: Klügl
authors.forename: Aris
authors.initials: A
authors.lastname: Liangos
authors.forename: Klaus J
authors.initials: KJ
authors.lastname: Gutleben
authors.forename: Johannes
authors.initials: J
authors.lastname: Brachmann
authors.forename: Anno
authors.initials: A
authors.lastname: Diegeler