Atrial fibrillation after transhiatal esophagectomy with transcervical endoscopic esophageal mobilization: one instituti
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RESEARCH ARTICLE
Open Access
Atrial fibrillation after transhiatal esophagectomy with transcervical endoscopic esophageal mobilization: one institution’s experience Elizabeth M. Colwell1* , Carlos O. Encarnacion2, Lisa E. Rein3, Aniko Szabo4, George Haasler5, Mario Gasparri6, William Tisol7 and David Johnstone5
Abstract Background: There have been numerous studies regarding atrial fibrillation (AF) associated with cardiac and pulmonary surgery; however, studies looking at esophagectomy and atrial fibrillation are sparse. The goal of this study was to review our institution’s atrial fibrillation rate following esophagectomy in order to better define the incidence and predisposing factors in this patient population. Methods: A retrospective chart review of all patients undergoing esophagectomy with transcervical endoscopic mobilization of the esophagus (TEEM) at the Medical College of Wisconsin and Affiliated Hospitals from July 2009 through December 2012. Results: Seventy-one patients underwent TEEM esophagectomy during the study period. Of those, 23 (32.4%) patients developed new atrial fibrillation postoperatively. ICU (Intensive Care Unit) length of stay was 7.1 days for those that did not receive amiodarone, compared to 5.3 days for those that did receive amiodarone (p < 0.025). Those that went into AF spent on average 9.3 days in the ICU compared to 4.7 days for their counterparts that did not go into AF (p < 0.006). Total length of stay was not statistically different between populations [15.1 +/− 11.3 days compared to 13.5 +/− 9.4 days for those who did not go into AF (p < 0.281)]. Receiving preoperative amiodarone was found to reduce the overall incidence of AF. There was a trend towards decreased risk of going into AF in those who received preoperative amiodarone with an adjusted hazard ratio of 0.555 (p = 0.057). Conclusion: Similar to data reported in previous literature, postoperative atrial fibrillation was found to increase ICU length of stay as well as overall length of hospital stay. Preoperative amiodarone administration displayed a trend toward decreasing the rates of atrial fibrillation in patients undergoing TEEM. Keywords: Esophagectomy, Atrial Fibrillation, Amiodarone
Background Atrial fibrillation (AF) after thoracic surgery is a common event. Its incidence, risk factors, and consequences have been extensively studied in patients undergoing cardiac surgery. More recently many authors have looked at AF after noncardiac thoracic surgery, reporting its occurrence between 12 and 44% [1] as well as showing an increase in * Correspondence: [email protected] 1 Cardiothoracic Surgery, Stanford University, 300 Pasteur Dr. Falk Cardiovascular Research Bldg, Stanford, CA 94305-5407, USA Full list of author information is available at the end of the article
morbidity and mortality in patients developing AF [2–4]. The few reports on postoperative AF after esophageal surgery have found that AF is common. It has been reported in up to 45% of patients following esophagectomy [5]. In 2003 Murthy et al
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