- Meeting abstract
- Open access
- Published:
Effect of beta blockers on the incidence of atrial fibrillation in elderly patients after abdominal surgery
BMC Surgery volume 13, Article number: A32 (2013)
Aim of the study
To determine whether treatment with Beta Blockers during abdominal surgery would reduce the incidence of post-operative Atrial Fibrillation (AF).
Background
Post operative AF is a common problem in patients following surgery. The incidence of such arrhythmia has been reported to range from 20–35% and increase to the age and to presence of comorbidities [1–3]. Also, AF is related to many complications and it is still debated what is the best interventions, especially in the elderly [4]. Sympathetic nervous system activation is strictly related to surgery stress [5] and treatment with Beta Blockers may reduce this overactivation that predispose to AF occurence [6–10].
Methods
A pilot study was conducted with 30 elderly patients (age > 65 years) who underwent abdominal surgery (right emicolectomy, sigmoidectomy and anterior rectal resection). They were randomized to control (ctr) (n = 14) and Beta Blockers (beta) (n = 16) groups. Before surgery all elderly patients have been taking Beta Blockers (for hypertension or heart failure). During and after surgery only the beta group received the medication. Both groups were well matched and had the same demographic and clinical characteristics.
Results
After surgery 5 patients of ctr group and in 1 patients of beta group developed AF (p < 0.001). All patients with AF occurrence were >75 years old.
Conclusions
Beta Blockers could not be stopped during abdominal surgery in elderly patients (with hypertension or heart failure) because significantly reduce the incidence of post-operative AF. Moreover, the link between the older age and AF occurrence is confirmed also in this population.
References
Rengo F, Parisi V, Rengo G, Femminella GD, Rengo C, Zincarelli C, Pagano G, Festa G, De Lucia C, Leosco D: Instruments for geriatric assessment: new multidimensional assessment approaches. JOURNAL OF NEPHROLOGY. 2012, 25: 73-78. 10.5301/jn.5000164. ISSN: 1121-8428, doi: 10.5301/jn.5000164
Pilotto A, Addante F, Franceschi M, Leandro G, Rengo G, D’Ambrosio P, Longo MG, Rengo F, Pellegrini F, Dallapiccola B, Ferrucci L: A Multidimensional Prognostic Index (MPI) based on a Comprehensive Geriatric Assessment Predicts Short-Term Mortality in Older Patients with Heart Failure. Circulation: Heart Failiure. 2010, 3: 14-20. 10.1161/CIRCHEARTFAILURE.109.865022.
Rengo F, Leosco D, Iacovoni A, Rengo G, Golino L, Borgia F, De Lisa G, Beneduce F, Senni M: Epidemiology and risk factors for heart failure in the elderly. Italian heart journal : official journal of the Italian Federation of Cardiology. 2004, 5 (Suppl 10): 9S-16S.
Rengo G, Pagano G, Squizzato A, Moja L, Femminella GD, de Lucia C, Komici K, Parisi V, Savarese G, Ferrara N, Perrone-Filardi P, Leosco D: Oral anticoagulation therapy in heart failure patients in sinus rhythm: a systematic review and meta-analysis. PloS One. 2013, 8 (1): e52952-10.1371/journal.pone.0052952. doi:10.1371/journal.pone.0052952
Paolillo S, Rengo G, Pagano G, Pellegrino T, Savarese G, Femminella GD, Tuccillo , Boemio A, Attena E, Formisano R, Petraglia L, Scopacasa F, Galasso G, Leosco D, Trimarco B, Cuocolo A, Perrone-Filardi P: Impact of Diabetes Mellitus on Cardiac Sympathetic Innervation in Patients With Heart Failure. A Iodine-123 meta-iodobenzylguanidine (I123MIBG) Scintigraphic Study. Diabetes Care. 2013
Rengo G, Lymperopoulos A, Zincarelli C, Femminella Gd, Liccardo D, Pagano G, de Lucia C, Cannavo A, Gargiulo P, Ferrara N, Perrone Filardi P, Koch Wj, Leosco D: Blockade of beta-adrenoceptors restores the GRK2-mediated adrenal alpha(2) -adrenoceptor-catecholamine production axis in heart failure. BRITISH JOURNAL OF PHARMACOLOGY. 2012, 166: 2430-2440. 10.1111/j.1476-5381.2012.01972.x. ISSN: 1476-5381, doi: 10.1111/j.1476-5381.2012.01972.x
Rengo G, Zincarelli C, Femminella GD, Liccardo D, Pagano G, de Lucia C, Altobelli GG, Cimini V, Ruggiero D, Perrone-Filardi P, Gao E, Ferrara N, Lymperopoulos A, Koch WJ, Leosco D: Myocardial beta(2) -adrenoceptor gene delivery promotes coordinated cardiac adaptive remodelling and angiogenesis in heart failure. BRITISH JOURNAL OF PHARMACOLOGY. 2012, 166: 2348-2361. 10.1111/j.1476-5381.2012.01954.x. ISSN: 1476-5381, doi: 10.1111/j.1476-5381.2012.01954.x
Rengo G, Perrone-Filardi P, Femminella GD, Liccardo D, Zincarelli C, de Lucia C, Pagano G, Marsico F, Lymperopoulos A, Leosco D: Targeting the beta-adrenergic receptor system through G-protein-coupled receptor kinase 2: a new paradigm for therapy and prognostic evaluation in heart failure: from bench to bedside. CIRCULATION. HEART FAILURE. 2012, 5: 385-391. 10.1161/CIRCHEARTFAILURE.112.966895. ISSN: 1941-3289, doi: 10.1161/CIRCHEARTFAILURE.112.966895
Rispoli C, Rocco N, Iannone L, Amato B: Developing guidelines in geriatric surgery: role of the grade system. BMC Geriatrics. 2009, 9 (SUPPL.1): A99-
Leosco D, Rengo G, Iaccarino G, Golino L, Marchese M, Fortunato F, Zincarelli C, Sanzari E, Ciccarelli M, Galasso G, Altobelli GG, Conti V, Matrone G, Cimini V, Ferrara N, Filippelli A, Koch WJ, Rengo F: Exercise promotes angiogenesis and improves β-adrenergic receptor signalling in the post-ischaemic failing rat heart. Cardiovascular Research. 2008, 30 (3):
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
About this article
Cite this article
Pagano, G., Leosco, D., Ferrara, N. et al. Effect of beta blockers on the incidence of atrial fibrillation in elderly patients after abdominal surgery. BMC Surg 13 (Suppl 1), A32 (2013). https://doi.org/10.1186/1471-2482-13-S1-A32
Published:
DOI: https://doi.org/10.1186/1471-2482-13-S1-A32