Atrial fibrillation after esophageal cancer surgery: an analysis of 207 consecutive patients
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The aim of this study was to identify perioperative risk factors that are associated with postoperative atrial fibrillation (AF) and the outcomes of different pharmacological interventions in esophageal cancer patients who underwent transthoracic esophagectomy.
This study included 207 patients who underwent a transthoracic esophagectomy for esophageal cancer resection by a single surgeon from January 1, 2004, through December 31, 2010.
Postoperative AF occurred in 19 patients (9.2 %), all of whom received antiarrhythmic drug therapy at the early stage. Antiarrhythmic treatment was effective in 12 cases (63.2 %). In this study, landiolol hydrochloride, an ultrashort-acting β1-selective β-blocker, was the first-line therapy for postoperative AF. A multivariate logistic regression analysis showed that postoperative AF was significantly associated with the use of an ileo-colon for reconstruction after esophagectomy (P = 0.0023, odds ratios [OR] = 13.6) and with the presence of tachycardia with a heart rate of >100 bpm on postoperative day (POD) 1 (P = 0.0004, OR = 18.4).
Postoperative AF is associated with the use of a colon conduit for reconstruction after esophagectomy and with tachycardia with a heart rate >100 bpm on POD 1. Identifying patients at high risk for postoperative AF will allow for more direct application of pharmacological methods of prophylaxis.
- Hou JL, Gao K, Li M, Ma JY, Shi YK, Wang Y, et al. Increased N-terminal pro-brain natriuretic peptide level predicts atrial fibrillation after surgery for esophageal carcinoma. World J Gastroenterol. 2008;28:2582–5. CrossRef
- Ma JY, Wang Y, Zhao YF, Wu Z, Liu LX, Kou YL, et al. Atrial fibrillation after surgery for esophageal carcinoma: clinical and prognostic significance. World J Gastroenterol. 2006;21:449–52.
- Amar D, Roistacher N, Burt M, Reinsel RA, Ginsberg RJ, Wilson RS. Clinical and echocardiographic correlates of symptomatic tachydysrhythmias after noncardiac thoracic surgery. Chest. 1995;108:349–54. CrossRef
- Amar D, Burt ME, Bains MS, Leung DH. Symptomatic tachydysrhythmias after esophagectomy: incidence and outcome measures. Ann Thorac Surg. 1996;61:1506–9. CrossRef
- Ritchie AJ, Whiteside M, Tolan M, McGuigan JA. Cardiac dysrhythmia in total thoracic oesophagectomy. A prospective study. Eur J Cardiothorac Surg. 1993;7:420–2. CrossRef
- Murthy SC, Law S, Whooley BP, Alexandrou A, Chu KM, Wong J. Atrial fibrillation after esophagectomy is a marker for postoperative morbidity and mortality. J Thorac Cardiovasc Surg. 2003;126:1162–7. CrossRef
- Viklund P, Lindblad M, Lu M, Ye W, Johansson J, Lagergren J. Risk factors for complications after esophageal cancer resection: a prospective population-based study in Sweden. Ann Surg. 2006;243:204–11. CrossRef
- Force S. The “innocent bystander” complications following esophagectomy: atrial fibrillation, recurrent laryngeal nerve injury, chylothorax, and pulmonary complications. Semin Thorac Cardiovasc Surg. 2004;16:117–23. CrossRef
- Atkins BZ, Shah AS, Hutcheson KA, Mangum JH, Pappas TN, Harpole DH Jr, et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg. 2004;78:1170–6. CrossRef
- Tisdale JE, Wroblewski HA, Wall DS, Rieger KM, Hammoud ZT, Young JV. A randomized, controlled study of amiodarone for prevention of atrial fibrillation after transthoracic esophagectomy. J Thorac Cardiovasc Surg. 2010;140:45–51. CrossRef
- Amar D, Zhang H, Heerdt PM, Park B, Fleisher M, Thaler HT. Statin use is associated with a reduction in atrial fibrillation after noncardiac thoracic surgery independent of C-reactive protein. Chest. 2005;128:3421–7. CrossRef
- Sezai A, Minami K, Nakai T, Hata M, Yoshitake I, Wakui S, et al. Landiolol hydrochloride for prevention of atrial fibrillation after coronary artery bypass grafting: new evidence from the PASCAL trial. J Thorac Cardiovasc Surg. 2011;141:1478–87. CrossRef
- Tisdale JE, Wroblewski HA, Kesler KA. Prophylaxis of atrial fibrillation after noncardiac thoracic surgery. Semin Thorac Cardiovasc Surg. 2010;22:310–20. CrossRef
- Vaporciyan AA, Correa AM, Rice DC, Roth JA, Smythe WR, Swisher SG, et al. Risk factors associated with atrial fibrillation after noncardiac thoracic surgery: analysis of 2588 patients. J Thorac Cardiovasc Surg. 2004;127:779–86. CrossRef
- Edge SB, Byrd DR, Compton CC, Fritz AG, GreeneFL, TrottiA. AJCC cancer staging manual. 7th edn. New York: Springer; 2009.
- American Thoracic Society. Standardization of spirometry, 1994 update. Am J Respir Crit Care Med. 1995;152:1107–36. CrossRef
- Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15:539–53. CrossRef
- Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19:68–74. CrossRef
- Kato K, Muro K, Minashi K, Ohtsu A, Ishikura S, Boku N, et al. Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for Stage II–III esophageal squamous cell carcinoma: JCOG trial (JCOG9906). Int J Radiat Oncol Biol Phys. 2011;81:684–90. CrossRef
- Luketich JD, Alvelo-Rivera M, Buenaventura PO, Christie NA, McCaughan JS, Litle VR, et al. Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg. 2003;238:486–94.
- Noshiro H, Iwasaki H, Kobayashi K, Uchiyama A, Miyasaka Y, Masatsugu T, et al. Lymphadenectomy along the left recurrent laryngeal nerve by a minimally invasive esophagectomy in the prone position for thoracic esophageal cancer. Surg Endosc. 2010;24:2965–73. CrossRef
- Bonavina L, Bona D, Binyom PR, Peracchia A. A laparoscopy-assisted surgical approach to esophageal carcinoma. J Surg Res. 2004;117:52–7. CrossRef
- Nakamura M, Iwahashi M, Nakamori M, Ishida K, Naka T, Iida T, et al. An analysis of the factors contributing to a reduction in the incidence of pulmonary complications following an esophagectomy for esophageal cancer. Langenbecks Arch Surg. 2008;393:127–33. CrossRef
- Iwahashi M, Nakamori M, Nakamura M, Ojima T, Naka T, Yamaue H. Optimal period for the prophylactic administration of neutrophil elastase inhibitor for patients with esophageal cancer undergoing esophagectomy. World J Surg. 2011;35:1573–9. CrossRef
- Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13. CrossRef
- Seely AJ, Ivanovic J, Threader J, Al-Hussaini A, Al-Shehab D, Ramsay T, et al. Systematic classification of morbidity and mortality after thoracic surgery. Ann Thorac Surg. 2010;90:936–42. CrossRef
- von Knorring J, Lepäntalo M, Lindgren L, Lindfors O. Cardiac arrhythmias and myocardial ischemia after thoracotomy for lung cancer. Ann Thorac Surg. 1992;53:642–7. CrossRef
- Passman RS, Gingold DS, Amar D, Lloyd-Jones D, Bennett CL, Zhang H, et al. Prediction rule for atrial fibrillation after major noncardiac thoracic surgery. Ann Thorac Surg. 2005;79:1698–703. CrossRef
- Cardinale D, Colombo A, Sandri MT, Lamantia G, Colombo N, Civelli M, et al. Increased perioperative N-terminal pro-B-type natriuretic peptide levels predict atrial fibrillation after thoracic surgery for lung cancer. Circulation. 2007;115:1339–44. CrossRef
- Stippel DL, Taylan C, Schröder W, Beckurts KT, Hölscher AH. Supraventricular tachyarrhythmia as early indicator of a complicated course after esophagectomy. Dis Esophagus. 2005;18:267–73. CrossRef
- Davis PA, Law S, Wong J. Colonic interposition after esophagectomy for cancer. Arch Surg. 2003;138:303–8. CrossRef
- Fuster V, Rydén LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary. J Am Coll Cardiol. 2001;38:1231–66. CrossRef
- Mangano DT, Layug EL, Wallace A, Tateo I. Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group. N Engl J Med. 1996;335:1713–20. CrossRef
- Atrial fibrillation after esophageal cancer surgery: an analysis of 207 consecutive patients
Volume 44, Issue 5 , pp 839-847
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Esophageal cancer
- Atrial fibrillation
- Industry Sectors
- Author Affiliations
- 1. Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
- 2. Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan