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Atrial Fibrillation and Risk of Postoperative Complications
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To the Editor: Dr Mathew and colleagues1 reported that atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery may be associated with a range of complications. It is unclear, however, whether AF is the cause or consequence of adverse outcomes such as renal failure, pneumonia, mediastinitis or deep sternal wound infections, sepsis, harvest site infections, vascular catheter infections, and genitourinary infections. Despite this uncertainty, Mathew et al recommended aggressive antiarrhythmic intervention for patients with recurrent AF.
By contrast, Crystal et al2 reported that although active drug therapy significantly reduced the absolute percentage of patients with AF by about 15%, such treatment did not decrease the incidence of stroke. Similarly, we3 found that although antiarrhythmic therapy significantly reduced the absolute risk of AF compared with placebo, this did not translate into any significant decrease in the risk of cerebrovascular accident. Antiarrhythmic treatment of AF does decrease the length of hospital . . . [Full Text of this Article]
Johann Auer, MD, FESC
johann.auer@khwels.at
Thomas Weber, MD;
Bernd Eber, MD, FESC
Department of Cardiology and Intensive Care
General Hospital Wels
Wels, Austria
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