Document Type
Article
Publication Date
3-27-2024
Manuscript Version
vor
Abstract
Introduction: Postoperative atrial fibrillation (POAF) is common following open heart surgery, and is associated with significant morbidity. Medications used for ventricular rate control of POAF may not be effective in controlling rapid ventricular rates during the postoperative period because of increased sympathetic tone. The purpose of this study was to develop nonpharmacologic rate control of POAF by atrioventricular node (AVN) fat pad stimulation using clinically available temporary pacing wires in the canine sterile pericarditis model. Methods: We studied 10 sterile pericarditis dogs in the closed-chest state on postoperative days 1−3. The AVN fat pad stimulation (amplitude 2–15 mA; frequency 20 Hz; pulse width 0.03–0.2 ms) was performed during sustained POAF (>5 min). We measured ventricular rate and inefficient ventricular contractions during sustained POAF and compared it with and without AVN fat pad stimulation. Also, the parameters of AVN fat pad stimulation to achieve a rate control of POAF were measured over the postoperative days. Results: Eleven episodes of sustained POAF were induced in 5/10 sterile pericarditis dogs in the closed-chest state on postoperative days 1−2. During POAF, the AVN fat pad stimulation decreased the ventricular rate from 178 ± 52 bpm to 100 ± 8 bpm in nine episodes. Nonpharmacologic rate control therapy successfully controlled the ventricular rate and eliminated inefficient ventricular contractions during POAF for the duration of the AVN fat pad stimulation. The AVN fat pad stimulation output remained relatively stable over the postoperative days. Conclusion: During sustained POAF, nonpharmacologic rate control by AVN fat pad stimulation effectively and safely controlled rapid ventricular rates throughout the postoperative period.
Keywords
atrioventricular node fat pad stimulation, nonpharmacologic rate control therapy, postoperative atrial fibrillation, rate control
Publication Title
Journal of Cardiovascular Electrophysiology
Rights
© 2024 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Lee, Seungyup; Wallick, Don; Khrestian, Celeen; Juzbasich, Dragan; Laurita, Daniel; Rushing, Gregory; and Sahadevan, Jayakumar, "Nonpharmacologic Rate Control of Postoperative Atrial Fibrillation in the Canine Sterile Pericarditis Model" (2024). Faculty Scholarship. 720.
https://commons.case.edu/facultyworks/720