logo
Medical news
of the North Caucasus
Scientific journal
Mass media registration certificate dated December 7, 2006.
Series ПИ #ФС 77-26521.
Federal service for surveillance over non-violation of the legislation in the sphere of mass communications and protection of cultural heritage.
ISSN 2073-8137
rus
русский
eng
english

Site search



Correspondence address
310 Mira Street, Stavropol, Russia, 355017

Tel
+7 8652 352524; +7 8652 353229.

Fax
+7 8652 352524.

E-mail
medvestnik@stgmu.ru

Prevention of new-onset atrial fibrillation after direct myocardial revascularization surgery: randomized comparative study

[Surgery]
Vladimir Kolesnikov; Olga Boeva; Alexandr Yagoda; Anna Ivanenko; Elena Danilova; Sergey Danilov;

In order to investigate the effect of Omegaven on the risk of paroxysms of atrial fibrillation lasting for more than 30 seconds, and other complications in the early postoperative period after coronary revascularization surgery, an open randomized comparative study was performed, which included 73 patients with CAD aged 41 75 (mean age 55 ± 7.1 years; 82.2% males) without valvular heart disease and a previous history of atrial fibrillation, hospitalized to undergo coronary artery bypass grafting under extracorporeal circulation. The main group included 33 patients treated with intravenous infusions of the Omegaven emulsion (100 ml / day, single dose) in the first 5–7 days after the surgery. The comparison group consisted of 40 patients who did not receive Omegaven.

The patients treated with Omegaven showed significantly lower rate of new-onset postoperative atrial fibrillation paroxysms (9.1% vs. 32.5%, р<0.01) and other life threatening cardiac arrhythmias and conduction disorders (25.0% vs. 6.1%, р<0.01), also revealing a statistically significant reduction in the duration of postoperative period (14.1 ±2.21 days vs. 22.9 ±3.82 days, р<0.05). The decrease in the relative risk of atrial fibrillation in the group in question was 72%. The study detected no side effects typical for Omegaven. The data obtained suggest that Omegaven may be administered to prevent the development of atrial fibrillation in the early postoperative period after coronary revascularization surgery.

Download

References:
1. Bokeriya L. A., Golukhova E. Z., Alekyan B. G. i dr. Resultaty khirurgicheskogo i endovasculyarnogo lecheniya bolnykh icshemicheskoy bolezn’yu serdtza: perioperatsionnye oslozhneniya, factory riska, prognoz. Kreativnaya cardiologiya. – Creative cardiology. 2011;1:41-60.
2. Panov A. V., Tatarskiy B. A., Gordeev M. L. i dr. Omega-3 polinenasyischennyie zhirnyie kislotyi v profilaktike fibrillyatsii predserdiy posle hirurgicheskoy revaskulyarizatsii miokarda. Ratsionalnaya farmakoterapiya v kardiologii. 2008;3:26-30.
3. Spravochnik Vidal «Lekarstvennyie preparatyi v Rossii». 2014:B874. http://medi.ru/doc/3221. htm>Omegaven
4. Almassi Н., Todd H. W., Carr B. et al. Postoperative Atrial fibrillation impacts costs and one-year clinical outcomes: the veterans affairs randomized on/off bypass trial. Ann Thorac Surg. 2015;99(1):109-114. doi. org/10.1016/j.athoracsur.2014.07.035.
5. Anselmi A., Possati G., Gaudino M. Postoperative inflammatory reaction and atrial fibrillation: simple correlation or causation? Ann Thorac Surg. 2009;88:326- 333. doi:10.1016/j.athoracsur.2009.01.031.
6. Bandeali S. J., Kayani W. T., Lee V.-V. et al. Virani outcomes of preoperative angiotensin-converting enzyme inhibitor therapy in patients undergoing isolated coronary artery bypass grafting. Am J Cardiol. 2012;110(7):919-923. doi:10.1111/1755- 5922.12024.
7. Zhang B., Zhen Y., Tao A., Bao Z., Zhang G. Polyunsaturated fatty acids for the prevention of atrial fibrillation after cardiac surgery: an updated meta-analysis of randomized controlled trials. J Cardiol. 2014;63(1):53-
59. doi.org/10.1016/j.jjcc.2013.06.014. 8. Benedetto U., Angeloni E., Melina G. et al. Polyunsaturated fatty acids for the prevention of postoperative
atrial fibrillation: a meta-analysis of randomized controlled trials. J Cardiovasc Med (Hagerstown, Md.). 2013;14:104-109.
9. Brinkman W., Herbert M. A., O’Brien S. et al. Preoperative β-blocker use in coronary artery bypass grafting surgery: national database analysis. JAMA Intern. Med. 2014;174(8):1320-1327. doi: 10.1001/jamainternmed. 2014.2356.
10. Calo L., Bianconi L., Colivicchi F. et al. N-3 fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial. J Am Coll Cardiol. 2005;45(10):1723-1728. doi. org/10.1016/j.jacc.2005.02.079.
11. Cao H., Wang X., Huang H. et al. Omega-3 fatty acids in the prevention of atrial fibrillation recurrences after cardioversion: a meta-analysis of randomized controlled trials. Intern Med. 2012;51:2503-2508.
12. Costanzo S., Di Niro V., Di Castelnuovo A. et al. Prevention of postoperative atrial fibrillation in open heart surgery patients by preoperative supplementation of n-3 polyunsaturated fatty acids: An updated meta-analysis. J Thorac Cardiovasc Surg. 2013;146(4):906-911. doi.org/10.1016/j.jtcvs.2013.03.015.
13. Caterina R., Bernini W., Carluccio M. A. et al. Structural requirements for inhibition of cytokine-induced endothelial activation by unsaturated fatty acids. J Lipid Research. 1998;39:1062-1070.
14. Echahidi N., Pibarot P., O’Hara G. et al. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery. J Am Coll Cardiol. 2008;51(8):793-801. doi.org/10.1016/j.jacc.2007.10.043.
15. Farquharson A. L., Metcalf R. G., Sanders P. et al. Effect of dietary fish oil on atrial fibrillation after cardiac surgery. Am J Cardiol. 2011;108(6):851-856. doi. org/10.1016/j.amjcard.2011.04.036.
16. Guo X.-Y., Yan X.-L., Chen Y.-W. et al. Omega-3 fatty acids for postoperative atrial fibrillation: alone or in combination with antioxidant vitamins? Heart, Lung & Circ. 2014;23(8):743-750. doi.org/10.1016/j. hlc.2014.02.018.
17. Hall J. A., Picton R. A., Skinner M. M. et al. The (n-3) fatty acid dose, independent of the (n-6) to (n-3) fatty acid ratio, affects the plasma fatty acid profile of normal dogs. J Nutr. 2006;136:2338-2344.
18. Harling L., Rasoli S., Vecht J. A. et al. Do antioxidant vitamin shave an antiarrhythmic effect following cardiac surgery? A meta-analysis of randomized controlled trials. Heart. 2011;97:1636-1642.
19. He Z., Yang L., Tian J. et al. Efficacy and safety of omega- 3 fatty acids for the prevention of atrial fibrillation: a meta-analysis. Canadian J Cardiol. 2013;29(2):196- 203. doi.org/10.1016/ j.cjca.2012.03.019.
20. Heidt M. C., Vician M., Stracke S. K. et al. Beneficial effects of intravenously administered N-3 fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a prospective randomized study. Thorac Cardiovasc Surg. 2009;57:276–280. doi:10.1055/s-0029-1185301
21. Korantzopoulos P., Kolettis T. M., Goudevenos J. A. et al. Effects of N-3 fatty acids on postoperative atrial fibrillation following coronary artery bypass surgery. J Amer Coll Cardiol. 2006;47(2):467-468. doi. org/10.1016/j.ijcard.2013.06.043.
22. Kourliouros A., Valencia O., Hosseini M. T. et al. Preoperative high-dose atorvastatin for prevention of atrial fibrillation after cardiac surgery: a randomized controlled trial. J Thorac Cardiovasc Surg. 2011;141(1):244-248. doi.org/10. 1016/j. jtcvs.2010.06.006.
23. Kumar S., Sutherland F., Rosso R. et al. Effects of chronic omega-3 polyunsaturated fatty acids supplementation on human atrial electrophysiology. Heart Rhythm. 2011;8:562-568. doi:10.1016/j.amjcard. 2011.03.082.
24. Lomivorotov V. V., Efremov S. M., Pokushalov E. A. et al. Randomized trial of fish oil infusion to prevent atrial fibrillation after cardiac surgery: data from an implantable continuous cardiac monitor. J Cardiothorac Vasc Anesth. 2014;28(5):1278-1284. doi.org/10.1053/j. jvca.2014.02.019.
25. Maesen B., Nijs J., Maessen J. et al. Postoperative atrial fibrillation: amaze of mechanisms. Europace. 2012;14:159-174
26. Mariscalco G., Klersy C., Zanobini M. et al. Atrial fibrillation after isolated coronary surgery affects late survival. Circulation. 2008;118:1612-1618.
27. Metcalf R. G., James M.J., Gibson R. A. et al. Effects of fish-oil supplementation on myocardial fatty acids in humans. Am J Clin Nutr. 2007;85:1222-1228.
28. Mitchell L. B. Canadian Cardiovascular Society atrial fibrillation guidelines 2010: prevention and treatment of atrial fibrillation following cardiac surgery. Canadian J Cardiol. 2011;27:91-97. doi:10.1016/j. cjca.2010.11.003.
29. Moreno C., Macías A., Prieto A. et al. Effects of n−3 polyunsaturated fatty acids on cardiac ion channels Front in Physiol. 2012;3:245. doi:10.3389/ fphys.2012.00245.
30. Mozaffarian D., Wu J. H. Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. Amer J Cardiol. 2011;58:2047-2067. doi:10.1016/j.jacc.2011.06.063.
31. Ozaydin M., Turker Y., Peker O. et al. Association between the use of non antiarrhythmic drugs and postoperative atrial fibrillation. Intern J Cardiol. 2010;144(2)304-306. doi.org/10.1016/j.ijcard. 2009.02.029.
32. Ramadeen A., Connelly K. A., Leong-Poi H. et at. Docosahexaenoic acid, but not eicosapentaenoic acid, supplementation reduces vulnerability to atrial fibrillation. Circulation: Arrhythm & Electrophysiol. 2012;5:978-983.
33. Reiffel J. A., Mc Donald A. Antiarrhythmic effects of omega-3 fatty acids. Amer J Cardiol. 2006;98:50-60.
34. Rodrigo R., Cereceda M., Castillo R. et al. Prevention of atrial fibrillation following cardiac surgery: Basis for a novel therapeutic strategy based on non hypoxic myocardial preconditioning. Pharmacol & Therapeut. 2008;118(1):104 127. doi.org/10.1016/j. pharmthera.2008. 01.005.
35. Rodrigo R., Korantzopoulos P., Cereceda M. et al. A randomized controlled trial to prevent postoperative atrial fibrillation by antioxidant reinforcement. J Amer Coll Cardiol. 2013. – Vol. 62. – P. 1457-1465. doi:10.1016/j.jacc.2013.07.014.
36. Sardar M. R., Saeed W., Kowey P. R. Antiarrhythmic Drug therapy for atrial fibrillation. Cardiol Clin. 2014;32(4):533-549. doi.org/10.1016/j. ccl.2014.07.012.
37. Sorice M., Tritto F. P., Sordelli C. et al. N-3 polyunsaturated fatty acids reduces post-operative atrial fibrillation incidence in patients undergoing ≪on pump≫ coronary artery bypass graft surgery. Monaldi Arch Chest Disease. 2011;76:93-98.
38. Steinberg B. A., Zhao Y., He X. et al. Management of postoperative atrial fibrillation and subsequent outcomes in contemporary patients undergoing cardiac surgery: insights from the Society of Thoracic Surgeons CAPS-Care Atrial Fibrillation Registry. Clin. Cardiol. 2014;37(1):7-13. doi: 10.1002/ clc.22230.
39. Van Osch D., Dieleman J. M., Van Dijk D. et al. Dexamethasone for the prevention of postoperative atrial fibrillation. Intern J Cardiol. 2015;182:431-437. doi. org/10.1016/j.ijcard.2014.12.094.
40. Zhou X., Du J.-L., Yuan J. et al. Statin therapy is beneficial for the prevention of atrial fibrillation in patients with coronary artery disease: A meta-analysis. Europ J Pharmacol. 2013;707(1-3):104-111. doi. org/10.1016/j.ejphar.2013.03.012.

Keywords: coronary artery bypass grafting, new-onset postoperative atrial fibrillation, prevention


Founders:
Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy