Incidence, predictors, and evolution of conduction disorders and atrial arrhythmias after contemporary mitral valve repair

Juan Viles Gonzalez, Alan D. Enriquez, Javier G. Castillo, James O. Coffey, Luciano Pastori, Vivek Y. Reddy, David H. Adams, Valentín Fuster

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Conduction disorders (CD) and atrial arrhythmias (AA) in the postoperative period of cardiac surgery impede prompt clinical recovery and prolong hospitalization. Mitral valve repair (MVR) has become the treatment of choice for patients with significant valvular regurgitation, but information on CD and AA in this population is scarce.

Methods: Records of consecutive patients undergoing MVR at a single center were reviewed. Patients with a preoperative pacemaker, CD, prior cardiac surgery or concomitant MVR were excluded. A total of 290 patients were included in the final analysis. Electrocardiograms pre- and post-operatively were analyzed for CD and AA.

Results: CD occurred in 69 (23.7%) patients: 47 (16.2%) had first degree atrio-ventricular block (AVB), 10 (3.4%) had Mobitz I, 3 (1.03%) had Mobitz II, and 9 (3.1%) complete AVB. Only 6 (2.0%) patients required pacemakers. Univariate predictors of AVB were age, preexisting right bundle branch block (RBBB), mitral valve ring size, and bypass time. The only multivariate predictors of AVB were bypass time and preexisting RBBB (OR 3.23 and 1.98, respectively). The most common AA was atrial fibrillation 13.1% (38 patients) followed by atrial flutter 2.7% (8 patients). Multivariate predictors of AA were age and left atrial size (OR 1.85 and 4.2, respectively). Length of stay in patients with CD or AA was prolonged 2.2 ± 2 days compared to controls (p < 0.05).

Conclusions: In this large sample of patients undergoing MVR, we found that bypass time and preexisting RBBB were independent predictors of CD; age and left atrial size were independent predictors of AA.

Original languageEnglish
Pages (from-to)569-575
Number of pages7
JournalCardiology Journal
Volume21
Issue number5
DOIs
StatePublished - Jan 1 2014

Fingerprint

Mitral Valve
Cardiac Arrhythmias
Incidence
Bundle-Branch Block
Thoracic Surgery
Atrial Flutter
Postoperative Period
Atrial Fibrillation
Length of Stay
Electrocardiography
Hospitalization

Keywords

  • Atrial fibrillation
  • Atrial flutter
  • Atrio-Ventricular block
  • conduction disorder
  • Mitral valve repair
  • Pacemaker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Viles Gonzalez, J., Enriquez, A. D., Castillo, J. G., Coffey, J. O., Pastori, L., Reddy, V. Y., ... Fuster, V. (2014). Incidence, predictors, and evolution of conduction disorders and atrial arrhythmias after contemporary mitral valve repair. Cardiology Journal, 21(5), 569-575. https://doi.org/10.5603/CJ.a2014.0016

Incidence, predictors, and evolution of conduction disorders and atrial arrhythmias after contemporary mitral valve repair. / Viles Gonzalez, Juan; Enriquez, Alan D.; Castillo, Javier G.; Coffey, James O.; Pastori, Luciano; Reddy, Vivek Y.; Adams, David H.; Fuster, Valentín.

In: Cardiology Journal, Vol. 21, No. 5, 01.01.2014, p. 569-575.

Research output: Contribution to journalArticle

Viles Gonzalez, J, Enriquez, AD, Castillo, JG, Coffey, JO, Pastori, L, Reddy, VY, Adams, DH & Fuster, V 2014, 'Incidence, predictors, and evolution of conduction disorders and atrial arrhythmias after contemporary mitral valve repair', Cardiology Journal, vol. 21, no. 5, pp. 569-575. https://doi.org/10.5603/CJ.a2014.0016
Viles Gonzalez, Juan ; Enriquez, Alan D. ; Castillo, Javier G. ; Coffey, James O. ; Pastori, Luciano ; Reddy, Vivek Y. ; Adams, David H. ; Fuster, Valentín. / Incidence, predictors, and evolution of conduction disorders and atrial arrhythmias after contemporary mitral valve repair. In: Cardiology Journal. 2014 ; Vol. 21, No. 5. pp. 569-575.
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abstract = "Background: Conduction disorders (CD) and atrial arrhythmias (AA) in the postoperative period of cardiac surgery impede prompt clinical recovery and prolong hospitalization. Mitral valve repair (MVR) has become the treatment of choice for patients with significant valvular regurgitation, but information on CD and AA in this population is scarce.Methods: Records of consecutive patients undergoing MVR at a single center were reviewed. Patients with a preoperative pacemaker, CD, prior cardiac surgery or concomitant MVR were excluded. A total of 290 patients were included in the final analysis. Electrocardiograms pre- and post-operatively were analyzed for CD and AA.Results: CD occurred in 69 (23.7{\%}) patients: 47 (16.2{\%}) had first degree atrio-ventricular block (AVB), 10 (3.4{\%}) had Mobitz I, 3 (1.03{\%}) had Mobitz II, and 9 (3.1{\%}) complete AVB. Only 6 (2.0{\%}) patients required pacemakers. Univariate predictors of AVB were age, preexisting right bundle branch block (RBBB), mitral valve ring size, and bypass time. The only multivariate predictors of AVB were bypass time and preexisting RBBB (OR 3.23 and 1.98, respectively). The most common AA was atrial fibrillation 13.1{\%} (38 patients) followed by atrial flutter 2.7{\%} (8 patients). Multivariate predictors of AA were age and left atrial size (OR 1.85 and 4.2, respectively). Length of stay in patients with CD or AA was prolonged 2.2 ± 2 days compared to controls (p < 0.05).Conclusions: In this large sample of patients undergoing MVR, we found that bypass time and preexisting RBBB were independent predictors of CD; age and left atrial size were independent predictors of AA.",
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T1 - Incidence, predictors, and evolution of conduction disorders and atrial arrhythmias after contemporary mitral valve repair

AU - Viles Gonzalez, Juan

AU - Enriquez, Alan D.

AU - Castillo, Javier G.

AU - Coffey, James O.

AU - Pastori, Luciano

AU - Reddy, Vivek Y.

AU - Adams, David H.

AU - Fuster, Valentín

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N2 - Background: Conduction disorders (CD) and atrial arrhythmias (AA) in the postoperative period of cardiac surgery impede prompt clinical recovery and prolong hospitalization. Mitral valve repair (MVR) has become the treatment of choice for patients with significant valvular regurgitation, but information on CD and AA in this population is scarce.Methods: Records of consecutive patients undergoing MVR at a single center were reviewed. Patients with a preoperative pacemaker, CD, prior cardiac surgery or concomitant MVR were excluded. A total of 290 patients were included in the final analysis. Electrocardiograms pre- and post-operatively were analyzed for CD and AA.Results: CD occurred in 69 (23.7%) patients: 47 (16.2%) had first degree atrio-ventricular block (AVB), 10 (3.4%) had Mobitz I, 3 (1.03%) had Mobitz II, and 9 (3.1%) complete AVB. Only 6 (2.0%) patients required pacemakers. Univariate predictors of AVB were age, preexisting right bundle branch block (RBBB), mitral valve ring size, and bypass time. The only multivariate predictors of AVB were bypass time and preexisting RBBB (OR 3.23 and 1.98, respectively). The most common AA was atrial fibrillation 13.1% (38 patients) followed by atrial flutter 2.7% (8 patients). Multivariate predictors of AA were age and left atrial size (OR 1.85 and 4.2, respectively). Length of stay in patients with CD or AA was prolonged 2.2 ± 2 days compared to controls (p < 0.05).Conclusions: In this large sample of patients undergoing MVR, we found that bypass time and preexisting RBBB were independent predictors of CD; age and left atrial size were independent predictors of AA.

AB - Background: Conduction disorders (CD) and atrial arrhythmias (AA) in the postoperative period of cardiac surgery impede prompt clinical recovery and prolong hospitalization. Mitral valve repair (MVR) has become the treatment of choice for patients with significant valvular regurgitation, but information on CD and AA in this population is scarce.Methods: Records of consecutive patients undergoing MVR at a single center were reviewed. Patients with a preoperative pacemaker, CD, prior cardiac surgery or concomitant MVR were excluded. A total of 290 patients were included in the final analysis. Electrocardiograms pre- and post-operatively were analyzed for CD and AA.Results: CD occurred in 69 (23.7%) patients: 47 (16.2%) had first degree atrio-ventricular block (AVB), 10 (3.4%) had Mobitz I, 3 (1.03%) had Mobitz II, and 9 (3.1%) complete AVB. Only 6 (2.0%) patients required pacemakers. Univariate predictors of AVB were age, preexisting right bundle branch block (RBBB), mitral valve ring size, and bypass time. The only multivariate predictors of AVB were bypass time and preexisting RBBB (OR 3.23 and 1.98, respectively). The most common AA was atrial fibrillation 13.1% (38 patients) followed by atrial flutter 2.7% (8 patients). Multivariate predictors of AA were age and left atrial size (OR 1.85 and 4.2, respectively). Length of stay in patients with CD or AA was prolonged 2.2 ± 2 days compared to controls (p < 0.05).Conclusions: In this large sample of patients undergoing MVR, we found that bypass time and preexisting RBBB were independent predictors of CD; age and left atrial size were independent predictors of AA.

KW - Atrial fibrillation

KW - Atrial flutter

KW - Atrio-Ventricular block

KW - conduction disorder

KW - Mitral valve repair

KW - Pacemaker

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