OBJECTIVE: The objective was to define the incidence of atrial fibrillation after video-assisted thoracic surgery lobectomy and determine whether video-assisted thoracic surgery reduces atrial fibrillation rate compared with thoracotomy. METHODS: With the use of a single-institution database of patients who underwent lobectomy for clinical stage I non-small cell lung cancer, 389 patients were identified who were in sinus rhythm preoperatively and received no prophylactic antiarrhythmics. Patients undergoing video-assisted thoracic surgery were age and gender matched with those undergoing thoracotomy. RESULTS: After matching, 122 patients undergoing video-assisted thoracic surgery and 122 patients undergoing thoracotomy were eligible for analysis. Patients undergoing video-assisted thoracic surgery had a higher preoperative diffusion capacity (92% +/- 28% vs 80% +/- 18% predicted, P = .001) and a lower rate of induction chemotherapy (5/122, 4% vs 11/122, 11%, P = .05) than patients undergoing thoracotomy. Atrial fibrillation occurred in 12% of patients (15/122) undergoing video-assisted thoracic surgery and 16% of patients (20/122) undergoing thoracotomy (P = .36). Overall, complications were lower in the video-assisted thoracic surgery group (17.2% vs 27.9%, P = .046). Patients with atrial fibrillation were older in both video-assisted thoracic surgery (73 +/- 7 years vs 66 +/- 9 years, P = .002) and thoracotomy groups (72 +/- 7 years vs 66 +/- 10 years, P = .005). Length of stay for patients with atrial fibrillation was greater in both video-assisted thoracic surgery (6.0 +/- 1.5 days vs 4.7 +/- 2.5 days, P = .01) and thoracotomy groups (9.2 +/- 4.3 days vs 6.8 +/- 3.6 days, P = .03). CONCLUSIONS: Regardless of surgical approach, atrial fibrillation after lobectomy occurred with equal frequency. This supports the theory that autonomic denervation and stress-mediated neurohumoral mechanisms are responsible for the pathogenesis of postoperative atrial fibrillation. Prophylaxis regimens against atrial fibrillation should be the same for either operative approach.
OBJECTIVE: The objective was to define the incidence of atrial fibrillation after video-assisted thoracic surgery lobectomy and determine whether video-assisted thoracic surgery reduces atrial fibrillation rate compared with thoracotomy. METHODS: With the use of a single-institution database of patients who underwent lobectomy for clinical stage I non-small cell lung cancer, 389 patients were identified who were in sinus rhythm preoperatively and received no prophylactic antiarrhythmics. Patients undergoing video-assisted thoracic surgery were age and gender matched with those undergoing thoracotomy. RESULTS: After matching, 122 patients undergoing video-assisted thoracic surgery and 122 patients undergoing thoracotomy were eligible for analysis. Patients undergoing video-assisted thoracic surgery had a higher preoperative diffusion capacity (92% +/- 28% vs 80% +/- 18% predicted, P = .001) and a lower rate of induction chemotherapy (5/122, 4% vs 11/122, 11%, P = .05) than patients undergoing thoracotomy. Atrial fibrillation occurred in 12% of patients (15/122) undergoing video-assisted thoracic surgery and 16% of patients (20/122) undergoing thoracotomy (P = .36). Overall, complications were lower in the video-assisted thoracic surgery group (17.2% vs 27.9%, P = .046). Patients with atrial fibrillation were older in both video-assisted thoracic surgery (73 +/- 7 years vs 66 +/- 9 years, P = .002) and thoracotomy groups (72 +/- 7 years vs 66 +/- 10 years, P = .005). Length of stay for patients with atrial fibrillation was greater in both video-assisted thoracic surgery (6.0 +/- 1.5 days vs 4.7 +/- 2.5 days, P = .01) and thoracotomy groups (9.2 +/- 4.3 days vs 6.8 +/- 3.6 days, P = .03). CONCLUSIONS: Regardless of surgical approach, atrial fibrillation after lobectomy occurred with equal frequency. This supports the theory that autonomic denervation and stress-mediated neurohumoral mechanisms are responsible for the pathogenesis of postoperative atrial fibrillation. Prophylaxis regimens against atrial fibrillation should be the same for either operative approach.
Authors: Mark F Berry; Nestor R Villamizar-Ortiz; Betty C Tong; William R Burfeind; David H Harpole; Thomas A D'Amico; Mark W Onaitis Journal: Ann Thorac Surg Date: 2010-04 Impact factor: 4.330
Authors: Gyorgy Frendl; Alissa C Sodickson; Mina K Chung; Albert L Waldo; Bernard J Gersh; James E Tisdale; Hugh Calkins; Sary Aranki; Tsuyoshi Kaneko; Stephen Cassivi; Sidney C Smith; Dawood Darbar; Jon O Wee; Thomas K Waddell; David Amar; Dale Adler Journal: J Thorac Cardiovasc Surg Date: 2014-06-30 Impact factor: 5.209
Authors: Emily P Ng; Frank O Velez-Cubian; Kathryn L Rodriguez; Matthew R Thau; Carla C Moodie; Joseph R Garrett; Jacques P Fontaine; Eric M Toloza Journal: J Thorac Dis Date: 2016-08 Impact factor: 2.895