title: Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery.
abstract: OBJECTIVE
  To study whether remote ischemic preconditioning (RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation (POAF).
  
  
  METHODS
  This was a prospective, single-center, single-blinded, randomized controlled study. One hundred and two patients were randomized to receive RIPC (3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia) or no RIPC (control). Primary outcome was POAF lasting for five minutes or longer during the first seven days after surgery. Secondary outcomes included length of hospital stay, incidence of inpatient mortality, myocardial infarction, and stroke.
  
  
  RESULTS
  POAF occurred at a rate of 54% in the RIPC group and 41.2% in the control group (P= 0.23). No statistically significant differences were noted in secondary outcomes between the two groups.
  
  
  CONCLUSIONS
  This is the first study in the United States to suggest that RIPC does not reduce POAF in patients with elective or urgent cardiac surgery. There were no differences in adverse effects in either group. Further studies are required to assess the relationship between RIPC and POAF.
authors.affiliation: Amir S Lotfi, Hossein Eftekhari, Auras R Atreya, Senthil K Sivalingam, Miguel Giannoni, Department of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, United States.
authors.forename: Amir S
authors.initials: AS
authors.lastname: Lotfi
authors.affiliation: Amir S Lotfi, Hossein Eftekhari, Auras R Atreya, Senthil K Sivalingam, Miguel Giannoni, Department of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, United States.
authors.forename: Hossein
authors.initials: H
authors.lastname: Eftekhari
authors.affiliation: Amir S Lotfi, Hossein Eftekhari, Auras R Atreya, Senthil K Sivalingam, Miguel Giannoni, Department of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, United States.
authors.forename: Auras R
authors.initials: AR
authors.lastname: Atreya
authors.affiliation: Amir S Lotfi, Hossein Eftekhari, Auras R Atreya, Senthil K Sivalingam, Miguel Giannoni, Department of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, United States.
authors.forename: Ananth
authors.initials: A
authors.lastname: Kashikar
authors.affiliation: Amir S Lotfi, Hossein Eftekhari, Auras R Atreya, Senthil K Sivalingam, Miguel Giannoni, Department of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, United States.
authors.forename: Senthil K
authors.initials: SK
authors.lastname: Sivalingam
authors.affiliation: Amir S Lotfi, Hossein Eftekhari, Auras R Atreya, Senthil K Sivalingam, Miguel Giannoni, Department of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, United States.
authors.forename: Miguel
authors.initials: M
authors.lastname: Giannoni
authors.affiliation: Amir S Lotfi, Hossein Eftekhari, Auras R Atreya, Senthil K Sivalingam, Miguel Giannoni, Department of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Visintainer
authors.affiliation: Amir S Lotfi, Hossein Eftekhari, Auras R Atreya, Senthil K Sivalingam, Miguel Giannoni, Department of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Engelman
keywords: Cardiac surgery; Chronic ischemic heart disease; Coronary artery disease; Other treatment; Post-operative atrial fibrillation; Remote ischemic preconditioning