Postoperative atrial fibrillation after ASD repair is associated with older age, preoperative left atrial dilatation, and postoperative overhydration.
This study was designed to clinically and experimentally elucidate the causes of atrial fibrillation (Af) and hemodynamic changes following open-heart surgery. In the clinical study of 94 patients aged 30 or above undergoing atrial septal defect (ASD) repair, postoperative outbreak of Af significantly related to advanced age above 50, large preoperative left atrial diameter above 40 mm, and postoperative overhydration. In the experimental study using electrically induced Af models in dogs, a fall in mean arterial pressure, a decrease in cardiac output and elevations in central venous and left atrial pressures were observed. During Af, aerobic metabolism of the cardiac muscle was accelarated. The electrical stimulation threshold for experimental Af significantly fell with elevations in atrial pressure. In conclusion, Af after open-heart surgery may relate to preoperative changes in the stimulation conduction systems which are indicated by left atrial dilatation and postoperative atrial distension due to overhydration.
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Susumu Ishikawa (1992) studied this question.
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