Research progress in electrical cardioversion of atrial fibrillation during perioperative cardiac surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YUAN Dou ¹ , CHEN Liping ² , LI Tao ³ ,  QIAN Yongjun ⁴

1. Department of Cardiovascular Surgery, Cheng Du Shang Jin Nan Fu Hospital, West China Hospital, Sichuan University, Chengdu, 611743, P. R. China;
2. Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
3. Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
4. Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

QIAN Yongjun, Email: qianyongjun@scu.edu.cn

Keywords：

Postcardiac surgery; atrial fibrillation; cardioversion; review

DOI：

10.7507/1007-4848.202010026

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. The existing treatment of postoperative AF mainly focuses on preoperative prevention, intraoperative protection and postoperative treatment for factors prone to AF before, during and after surgery, but the postoperative treatment in various areas and hospitals is different. This article combines the latest literature published in Europace about the practice guidance of cardioversion of AF and atrial flutter, and summarizes the treatment of electrical cardioversion, in order to provide clinical guidance for electrical cardioversion of AF after cardiac surgery.

Citation： YUAN Dou, CHEN Liping, LI Tao, QIAN Yongjun. Research progress in electrical cardioversion of atrial fibrillation during perioperative cardiac surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(4): 514-518. doi: 10.7507/1007-4848.202010026 Copy

1.	Izhar U, Ad N, Rudis E, et al. When should we discontinue antiarrhythmic therapy for atrial fibrillation after coronary artery bypass grafting? A prospective randomized study. J Thorac Cardiovasc Surg, 2005, 129(2): 401-406.
2.	Melduni RM, Schaff HV, Bailey KR, et al. Implications of new-onset atrial fibrillation after cardiac surgery on long-term prognosis: A community-based study. Am Heart J, 2015, 170(4): 659-668.
3.	Arakawa M, Miyata H, Uchida N, et al. Postoperative atrial fibrillation after thoracic aortic surgery. Ann Thorac Surg, 2015, 99(1): 103-108.
4.	Verma A, Bhatt DL, Verma S. Long-term outcomes of post-operative atrial fibrillation: Guilty as charged. J Am Coll Cardiol, 2018, 71(7): 749-751.
5.	Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Kardiol Pol, 2018, 76(12): 1585-1664.
6.	Brandes A, Crijns HJGM, Rienstra M, et al. Cardioversion of atrial fibrillation and atrial flutter revisited: current evidence and practical guidance for a common procedure. Europace, 2020, 22(8): 1149-1161.
7.	Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace, 2016, 18(11): 1609-1678.
8.	Aktas MK, Khan MN, Di Biase L, et al. Higher rate of recurrent atrial flutter and atrial fibrillation following atrial flutter ablation after cardiac surgery. J Cardiovasc Electrophysiol, 2010, 21(7): 760-765.
9.	Twomey DJ, Sanders P, Roberts-Thomson KC. Atrial macroreentry in congenital heart disease. Curr Cardiol Rev, 2015, 11(2): 141-148.
10.	Zaman AG, Archbold RA, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery: A model for preoperative risk stratification. Circulation, 2000, 101(12): 1403-1408.
11.	Dobrev D, Aguilar M, Heijman J, et al. Postoperative atrial fibrillation: Mechanisms, manifestations and management. Nat Rev Cardiol, 2019, 16(7): 417-436.
12.	January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation, 2014, 130(23): e199-e267.
13.	Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg, 1996, 61(2): 755-759.
14.	Beigel R, Wunderlich NC, Ho SY, et al. The left atrial appendage: Anatomy, function, and noninvasive evaluation. JACC Cardiovasc Imaging, 2014, 7(12): 1251-1265.
15.	Manning WJ, Weintraub RM, Waksmonski CA, et al. Accuracy of transesophageal echocardiography for identifying left atrial thrombi. A prospective, intraoperative study. Ann Intern Med, 1995, 123(11): 817-822.
16.	Cappato R, Ezekowitz MD, Klein AL, et al. Rivaroxaban vs. vitamin K antagonists for cardioversion in atrial fibrillation. Eur Heart J, 2014, 35(47): 3346-3355.
17.	Goette A, Merino JL, Ezekowitz MD, et al. Edoxaban versus enoxaparin-warfarin in patients undergoing cardioversion of atrial fibrillation (ENSURE-AF): A randomised, open-label, phase 3b trial. Lancet, 2016, 388(10055): 1995-2003.
18.	Lip GY, Hammerstingl C, Marin F, et al. Left atrial thrombus resolution in atrial fibrillation or flutter: Results of a prospective study with rivaroxaban (X-TRA) and a retrospective observational registry providing baseline data (CLOT-AF). Am Heart J, 2016, 178: 126-134.
19.	Gallagher MM, Hennessy BJ, Edvardsson N, et al. Embolic complications of direct current cardioversion of atrial arrhythmias: Association with low intensity of anticoagulation at the time of cardioversion. J Am Coll Cardiol, 2002, 40(5): 926-933.
20.	Hansen ML, Jepsen RM, Olesen JB, et al. Thromboembolic risk in 16274 atrial fibrillation patients undergoing direct current cardioversion with and without oral anticoagulant therapy. Europace, 2015, 17(1): 18-23.
21.	Airaksinen KE, Grönberg T, Nuotio I, et al. Thromboembolic complications after cardioversion of acute atrial fibrillation: The FinCV (Finnish CardioVersion) study. J Am Coll Cardiol, 2013, 62(13): 1187-1192.
22.	Crijns HJ, Weijs B, Fairley AM, et al. Contemporary real life cardioversion of atrial fibrillation: Results from the multinational RHYTHM-AF study. Int J Cardiol, 2014, 172(3): 588-594.
23.	Kochiadakis GE, Igoumenidis NE, Parthenakis FI, et al. Amiodarone versus propafenone for conversion of chronic atrial fibrillation: Results of a randomized, controlled study. J Am Coll Cardiol, 1999, 33(4): 966-971.
24.	Tieleman RG, Gosselink AT, Crijns HJ, et al. Efficacy, safety, and determinants of conversion of atrial fibrillation and flutter with oral amiodarone. Am J Cardiol, 1997, 79(1): 53-57.
25.	Kirchhof P, Mönnig G, Wasmer K, et al. A trial of self-adhesive patch electrodes and hand-held paddle electrodes for external cardioversion of atrial fibrillation (MOBIPAPA). Eur Heart J, 2005, 26(13): 1292-1297.
26.	Manegold JC, Israel CW, Ehrlich JR, et al. External cardioversion of atrial fibrillation in patients with implanted pacemaker or cardioverter-defibrillator systems: A randomized comparison of monophasic and biphasic shock energy application. Eur Heart J, 2007, 28(14): 1731-1738.
27.	Inácio JF, da Rosa Mdos S, Shah J, et al. Monophasic and biphasic shock for transthoracic conversion of atrial fibrillation: Systematic review and network meta-analysis. Resuscitation, 2016, 100: 66-75.
28.	Van Gelder IC, Tuinenburg AE, Schoonderwoerd BS, et al. Pharmacologic versus direct-current electrical cardioversion of atrial flutter and fibrillation. Am J Cardiol, 1999, 84(9A): 147R-151R.
29.	Weijs B, Limantoro I, Delhaas T, et al. Cardioversion of persistent atrial fibrillation is associated with a 24-hour relapse gap: Observations from prolonged postcardioversion rhythm monitoring. Clin Cardiol, 2018, 41(3): 366-371.
30.	Tieleman RG, Van Gelder IC, Crijns HJ, et al. Early recurrences of atrial fibrillation after electrical cardioversion: A result of fibrillation-induced electrical remodeling of the atria? J Am Coll Cardiol, 1998, 31(1): 167-173.
31.	Li T, Qian Y. Precise drug sequential therapy can improve the cardioversion rate of atrial fibrillation with valvular disease after radiofrequency ablation. Methods Mol Biol, 2020, 2204: 145-159.
32.	Kühlkamp V, Schirdewan A, Stangl K, et al. Use of metoprolol CR/XL to maintain sinus rhythm after conversion from persistent atrial fibrillation: A randomized, double-blind, placebo-controlled study. J Am Coll Cardiol, 2000, 36(1): 139-146.
33.	Lip GY. Cardioversion of atrial fibrillation. Postgrad Med J, 1995, 71(838): 457-465.
34.	Berger M, Schweitzer P. Timing of thromboembolic events after electrical cardioversion of atrial fibrillation or flutter: A retrospective analysis. Am J Cardiol, 1998, 82(12): 1545-1547.
35.	Femia G, Fetahovic T, Shetty P, et al. Novel oral anticoagulants in direct current cardioversion for atrial fibrillation. Heart Lung Circ, 2018, 27(7): 798-803.
36.	Itäinen S, Lehto M, Vasankari T, et al. Non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients undergoing elective cardioversion. Europace, 2018, 20(4): 565-568.
37.	Goette A, Kwong WJ, Ezekowitz MD, et al. Edoxaban therapy increases treatment satisfaction and reduces utilization of healthcare resources: An analysis from the EdoxabaN vs. warfarin in subjectS UndeRgoing cardiovErsion of atrial fibrillation (ENSURE-AF) study. Europace, 2018, 20(12): 1936-1943.
38.	Lip GYH, Collet JP, Haude M, et al. 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions: A joint consensus document of the European Heart Rhythm Association (EHRA), European Society of Cardiology Working Group on Thrombosis, European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA). Europace, 2019, 21(2): 192-193.
39.	Vinereanu D, Lopes RD, Bahit MC, et al. A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): An international, cluster-randomised trial. Lancet, 2017, 390(10104): 1737-1746.

1. Izhar U, Ad N, Rudis E, et al. When should we discontinue antiarrhythmic therapy for atrial fibrillation after coronary artery bypass grafting? A prospective randomized study. J Thorac Cardiovasc Surg, 2005, 129(2): 401-406.
2. Melduni RM, Schaff HV, Bailey KR, et al. Implications of new-onset atrial fibrillation after cardiac surgery on long-term prognosis: A community-based study. Am Heart J, 2015, 170(4): 659-668.
3. Arakawa M, Miyata H, Uchida N, et al. Postoperative atrial fibrillation after thoracic aortic surgery. Ann Thorac Surg, 2015, 99(1): 103-108.
4. Verma A, Bhatt DL, Verma S. Long-term outcomes of post-operative atrial fibrillation: Guilty as charged. J Am Coll Cardiol, 2018, 71(7): 749-751.
5. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Kardiol Pol, 2018, 76(12): 1585-1664.
6. Brandes A, Crijns HJGM, Rienstra M, et al. Cardioversion of atrial fibrillation and atrial flutter revisited: current evidence and practical guidance for a common procedure. Europace, 2020, 22(8): 1149-1161.
7. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace, 2016, 18(11): 1609-1678.
8. Aktas MK, Khan MN, Di Biase L, et al. Higher rate of recurrent atrial flutter and atrial fibrillation following atrial flutter ablation after cardiac surgery. J Cardiovasc Electrophysiol, 2010, 21(7): 760-765.
9. Twomey DJ, Sanders P, Roberts-Thomson KC. Atrial macroreentry in congenital heart disease. Curr Cardiol Rev, 2015, 11(2): 141-148.
10. Zaman AG, Archbold RA, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery: A model for preoperative risk stratification. Circulation, 2000, 101(12): 1403-1408.
11. Dobrev D, Aguilar M, Heijman J, et al. Postoperative atrial fibrillation: Mechanisms, manifestations and management. Nat Rev Cardiol, 2019, 16(7): 417-436.
12. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation, 2014, 130(23): e199-e267.
13. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg, 1996, 61(2): 755-759.
14. Beigel R, Wunderlich NC, Ho SY, et al. The left atrial appendage: Anatomy, function, and noninvasive evaluation. JACC Cardiovasc Imaging, 2014, 7(12): 1251-1265.
15. Manning WJ, Weintraub RM, Waksmonski CA, et al. Accuracy of transesophageal echocardiography for identifying left atrial thrombi. A prospective, intraoperative study. Ann Intern Med, 1995, 123(11): 817-822.
16. Cappato R, Ezekowitz MD, Klein AL, et al. Rivaroxaban vs. vitamin K antagonists for cardioversion in atrial fibrillation. Eur Heart J, 2014, 35(47): 3346-3355.
17. Goette A, Merino JL, Ezekowitz MD, et al. Edoxaban versus enoxaparin-warfarin in patients undergoing cardioversion of atrial fibrillation (ENSURE-AF): A randomised, open-label, phase 3b trial. Lancet, 2016, 388(10055): 1995-2003.
18. Lip GY, Hammerstingl C, Marin F, et al. Left atrial thrombus resolution in atrial fibrillation or flutter: Results of a prospective study with rivaroxaban (X-TRA) and a retrospective observational registry providing baseline data (CLOT-AF). Am Heart J, 2016, 178: 126-134.
19. Gallagher MM, Hennessy BJ, Edvardsson N, et al. Embolic complications of direct current cardioversion of atrial arrhythmias: Association with low intensity of anticoagulation at the time of cardioversion. J Am Coll Cardiol, 2002, 40(5): 926-933.
20. Hansen ML, Jepsen RM, Olesen JB, et al. Thromboembolic risk in 16274 atrial fibrillation patients undergoing direct current cardioversion with and without oral anticoagulant therapy. Europace, 2015, 17(1): 18-23.
21. Airaksinen KE, Grönberg T, Nuotio I, et al. Thromboembolic complications after cardioversion of acute atrial fibrillation: The FinCV (Finnish CardioVersion) study. J Am Coll Cardiol, 2013, 62(13): 1187-1192.
22. Crijns HJ, Weijs B, Fairley AM, et al. Contemporary real life cardioversion of atrial fibrillation: Results from the multinational RHYTHM-AF study. Int J Cardiol, 2014, 172(3): 588-594.
23. Kochiadakis GE, Igoumenidis NE, Parthenakis FI, et al. Amiodarone versus propafenone for conversion of chronic atrial fibrillation: Results of a randomized, controlled study. J Am Coll Cardiol, 1999, 33(4): 966-971.
24. Tieleman RG, Gosselink AT, Crijns HJ, et al. Efficacy, safety, and determinants of conversion of atrial fibrillation and flutter with oral amiodarone. Am J Cardiol, 1997, 79(1): 53-57.
25. Kirchhof P, Mönnig G, Wasmer K, et al. A trial of self-adhesive patch electrodes and hand-held paddle electrodes for external cardioversion of atrial fibrillation (MOBIPAPA). Eur Heart J, 2005, 26(13): 1292-1297.
26. Manegold JC, Israel CW, Ehrlich JR, et al. External cardioversion of atrial fibrillation in patients with implanted pacemaker or cardioverter-defibrillator systems: A randomized comparison of monophasic and biphasic shock energy application. Eur Heart J, 2007, 28(14): 1731-1738.
27. Inácio JF, da Rosa Mdos S, Shah J, et al. Monophasic and biphasic shock for transthoracic conversion of atrial fibrillation: Systematic review and network meta-analysis. Resuscitation, 2016, 100: 66-75.
28. Van Gelder IC, Tuinenburg AE, Schoonderwoerd BS, et al. Pharmacologic versus direct-current electrical cardioversion of atrial flutter and fibrillation. Am J Cardiol, 1999, 84(9A): 147R-151R.
29. Weijs B, Limantoro I, Delhaas T, et al. Cardioversion of persistent atrial fibrillation is associated with a 24-hour relapse gap: Observations from prolonged postcardioversion rhythm monitoring. Clin Cardiol, 2018, 41(3): 366-371.
30. Tieleman RG, Van Gelder IC, Crijns HJ, et al. Early recurrences of atrial fibrillation after electrical cardioversion: A result of fibrillation-induced electrical remodeling of the atria? J Am Coll Cardiol, 1998, 31(1): 167-173.
31. Li T, Qian Y. Precise drug sequential therapy can improve the cardioversion rate of atrial fibrillation with valvular disease after radiofrequency ablation. Methods Mol Biol, 2020, 2204: 145-159.
32. Kühlkamp V, Schirdewan A, Stangl K, et al. Use of metoprolol CR/XL to maintain sinus rhythm after conversion from persistent atrial fibrillation: A randomized, double-blind, placebo-controlled study. J Am Coll Cardiol, 2000, 36(1): 139-146.
33. Lip GY. Cardioversion of atrial fibrillation. Postgrad Med J, 1995, 71(838): 457-465.
34. Berger M, Schweitzer P. Timing of thromboembolic events after electrical cardioversion of atrial fibrillation or flutter: A retrospective analysis. Am J Cardiol, 1998, 82(12): 1545-1547.
35. Femia G, Fetahovic T, Shetty P, et al. Novel oral anticoagulants in direct current cardioversion for atrial fibrillation. Heart Lung Circ, 2018, 27(7): 798-803.
36. Itäinen S, Lehto M, Vasankari T, et al. Non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients undergoing elective cardioversion. Europace, 2018, 20(4): 565-568.
37. Goette A, Kwong WJ, Ezekowitz MD, et al. Edoxaban therapy increases treatment satisfaction and reduces utilization of healthcare resources: An analysis from the EdoxabaN vs. warfarin in subjectS UndeRgoing cardiovErsion of atrial fibrillation (ENSURE-AF) study. Europace, 2018, 20(12): 1936-1943.
38. Lip GYH, Collet JP, Haude M, et al. 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions: A joint consensus document of the European Heart Rhythm Association (EHRA), European Society of Cardiology Working Group on Thrombosis, European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA). Europace, 2019, 21(2): 192-193.
39. Vinereanu D, Lopes RD, Bahit MC, et al. A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): An international, cluster-randomised trial. Lancet, 2017, 390(10104): 1737-1746.

Previous Article
Preliminary study of reasonable and feasible safe distance for radical resection of hepatic alveolar echinococcosis
Next Article
甲状腺癌颈淋巴结清扫术后难治性乳糜漏临床分析

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Research progress in electrical cardioversion of atrial fibrillation during perioperative cardiac surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content