Key result
Posterior pericardiotomy significantly reduced early pericardial effusion compared to control (8% vs 38%, P<0.0001) but had no significant effect on postoperative atrial fibrillation.
Why the study?
Postoperative atrial fibrillation is a common problem after cardiac surgery related to increased morbidity and hospital costs, prompting evaluation of whether posterior pericardiotomy reduces postoperative pericardial effusion and related atrial fibrillation.
Does posterior pericardiotomy reduce postoperative pericardial effusion and atrial fibrillation in patients undergoing cardiac surgery?
RCT (n=100)
Yes
Does posterior pericardiotomy reduce postoperative pericardial effusion and atrial fibrillation in patients undergoing cardiac surgery?
Absolute Event Rate: 8% vs 38%
p-value: p=<0.0001
Posterior pericardiotomy significantly reduces early and late postoperative pericardial effusion but does not significantly reduce the incidence of postoperative atrial fibrillation.
Drafting clause 1 (Clinical): Supports posterior pericardiotomy as a.
Background: Postoperative atrial fibrillation is common problem after cardiac surgeries. It is related to the rise in morbidity & hospital costs. Objective: The goal of the research was to assess the effectiveness of posterior pericardiotomy in reducing the incidence of postoperative pericardial effusion & consequently decreasing the related atrial fibrillation. Subjects and Methods: This randomized research included 100 patients scheduled for cardiac surgery in Kasr Al-Ainy Hospital, Cairo University & Fayoum University Hospital, Department of Cardiothoracic Surgery between March 2022 and September 2022. Studied cases were separated into 2 groups; each group included fifty studied cases, the posterior pericardiotomy group (group A) and control group (group B). Postoperative evaluations were made after five & thirty days and contained electrocardiographic research, chest x-ray, & echocardiography. Results: Early pericardial effusion developed in 4 studied cases (8%) in group A & 19 studied cases (38%) in group B (P<0.0001). No late pericardial effusion in group A compared to nine (18%) cases had late pericardial effusion in group B (P=0.002). Atrial fibrillation developed in 8 patients (16%) in group (A) & in 11 patients (22%) in group B (P=0.444). Conclusion: Posterior pericardiotomy is safe method that significantly decreases the incidence of early & late postoperative pericardial effusion and tamponade, but it has no significant effect in reduction of postoperative AF.
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Singer et al. (2022) conducted an RCT in Postoperative pericardial effusion and atrial fibrillation (n=100). Posterior pericardiotomy vs. Control group was evaluated on Early pericardial effusion (p=<0.0001). Posterior pericardiotomy significantly reduced early pericardial effusion compared to control (8% vs 38%, P<0.0001) but had no significant effect on postoperative atrial fibrillation.
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