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Atrial fibrillation after transhiatal esophagectomy with transcervical endoscopic esophageal mobilization: one institution's experience. J Cardiothorac Surg 2018 Jun 19;13(1):73 PMID: 29921284 PMCID: PMC6007001

Pubmed ID

29921284

Abstract

BACKGROUND: There have been numerous studies regarding atrial fibrillation (AF) associated with cardiac and pulmonary surgery; however, studies looking at esophagectomy and atrial fibrillation are sparse. The goal of this study was to review our institution's atrial fibrillation rate following esophagectomy in order to better define the incidence and predisposing factors in this patient population.

METHODS: A retrospective chart review of all patients undergoing esophagectomy with transcervical endoscopic mobilization of the esophagus (TEEM) at the Medical College of Wisconsin and Affiliated Hospitals from July 2009 through December 2012.

RESULTS: Seventy-one patients underwent TEEM esophagectomy during the study period. Of those, 23 (32.4%) patients developed new atrial fibrillation postoperatively. ICU (Intensive Care Unit) length of stay was 7.1 days for those that did not receive amiodarone, compared to 5.3 days for those that did receive amiodarone (p < 0.025). Those that went into AF spent on average 9.3 days in the ICU compared to 4.7 days for their counterparts that did not go into AF (p < 0.006). Total length of stay was not statistically different between populations [15.1 +/- 11.3 days compared to 13.5 +/- 9.4 days for those who did not go into AF (p < 0.281)]. Receiving preoperative amiodarone was found to reduce the overall incidence of AF. There was a trend towards decreased risk of going into AF in those who received preoperative amiodarone with an adjusted hazard ratio of 0.555 (p = 0.057).

CONCLUSION: Similar to data reported in previous literature, postoperative atrial fibrillation was found to increase ICU length of stay as well as overall length of hospital stay. Preoperative amiodarone administration displayed a trend toward decreasing the rates of atrial fibrillation in patients undergoing TEEM.

Author List

Colwell EM, Encarnacion CO, Rein LE, Szabo A, Haasler G, Gasparri M, Tisol W, Johnstone D

Authors

Mario G. Gasparri MD Professor in the Surgery department at Medical College of Wisconsin
Aniko Szabo PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-85048791354

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Atrial Fibrillation
Esophagectomy
Esophagoscopy
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Outcome Assessment (Health Care)
Postoperative Complications
Retrospective Studies
Risk Factors
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6