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Prevention of perioperative atrial fibrillation with beta blockers in elderly patient during abdominal surgery

Aim of the study

To investigate whether pharmacologic prophylaxis with Beta Blocker Carvedilol reduce perioperative Atrial Fibrillation (AF) in elderly patients during abdominal surgery.

Background

Peri-operative AF is the consequence of stress activation of Sympathetic Nervous System (SNS) following surgery [1, 2]. The incidence of AF increase with the aging and in presence of comorbidities [35]. Clinical consequences include reduced cardiac output, lengthened hospitalization, an increase in the risk of cerebral thromboembolism and in many cases the need for systemic anticoagulation [6]. SNS overactivation could be treated with Beta Blockers and may reduce the occurrence of AF [710].

Methods

A prospective, randomized, single-blind, controlled pilot study in patients undergoing abdominal surgery (right emicolectomy, sigmoidectomy and anterior rectal resection) was conducted. 22 elderly patients (70 years old and over) were randomized to control (ctr) (n = 13) and Carvedilol (carv) (n = 9) groups. Treatment was received only during and 36 hours after surgery in the carv group.

Results

The occurrence of AF were 3 in ctr group and in 0 in carv group (p < 0.0001). No statistical differences were present in demographic and clinical characteristics between two groups. No correlation was found between age and the incidence of AF..

Conclusions

In the elderly patients underwent abdominal surgery, the reduction of SNS with Beta Blocker Carvedilol should be useful to reduce the occurrence of peri-operative AF and, consequently, to reduce the impact of AF cardiovascular complications.

References

  1. Rengo G, Leosco D, Zincarelli C, Marchese M, Corbi G, Liccardo D, Filippelli A, Ferrara N, Lisanti MP, Koch WJ, Lymperopoulos A: Adrenal GRK2 lowering is an underlying mechanism for the beneficial sympathetic effects of exercise training in heart failure. American Journal of Physiology - Heart and Circulatory Physiology. 2010, 24 (9):

  2. 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):

  3. 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

    Article  Google Scholar 

  4. 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.

    Google Scholar 

  5. 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-

    Google Scholar 

  6. 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

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. 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

    Google Scholar 

  8. 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

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. 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

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. 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

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Gennaro Pagano.

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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.

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Pagano, G., Leosco, D., Ferrara, N. et al. Prevention of perioperative atrial fibrillation with beta blockers in elderly patient during abdominal surgery. BMC Surg 13 (Suppl 1), A34 (2013). https://doi.org/10.1186/1471-2482-13-S1-A34

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