INCIDENCE OF POST-OPERATIVE ATRIAL FIBRILLATION IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING SURGERY AFTER GIVING PERIOPERATIVE BETA BLOCKERS:A PROSPECTIVE OBSERVATIONAL STUDY IN A UNIVERSITY HOSPITAL IN PALESTINE
| dc.contributor.author | Duha Zaki | |
| dc.date.accessioned | 2024-05-30T12:17:11Z | |
| dc.date.available | 2024-05-30T12:17:11Z | |
| dc.date.issued | 2022-08-24 | |
| dc.description.abstract | ABSTRACT Background: The most prevalent arrhythmia, after cardiac surgery, is postoperative atrial fibrillation (POAF).It affects 30% to 50% of patients and significantly increases morbidity and length of hospital stay. Also, it significantly increases hospital costs. A number of risk factors have been found to be associated with a higher frequency of post-coronary artery bypass grafting (CABG) AF. Beta-blockers emerge as the preventive drug, unanimously regarded as a therapy assisting in the reduction of POAF incidence. Aim: This study sought to determine the incidence of postoperative atrial fibrillation in patients undergoing on-pump CABG surgery after perioperative beta blocker (Bisoprolol) administration. Material and method: Patients were scheduled for elective CABG surgery in this prospective observational trial. Valve surgery, redo CABG surgery, and renal failure patients were excluded from the study. The (Already on Beta-Blockers) group and the (Newly Administered of Beta-blockers-Bisoprolol) group were afterwards formed from the original one group of the study sample for the purposes of analysis. Patients who were already taking beta-blockers (Already on Beta-Blockers) should continue taking them postoperatively after being extubated and awakened. They should start taking them the evening before surgery. For patients who were receiving beta blockers for the first time postoperatively( Newly Administered of Beta-blockers-Bisoprolol) and they were not on beta blocker preoperatively, the dose was adjusted according to heart rate, and blood pressure starting from 1.25mgBisoprolol (orally) and titrating according to previous parameters Results: The incidence of POAF stood at 17/150 (11.3%) post operatively in the whole group, when a subgroup analysis was done, the whole group was divided into two groups: group one Already on Beta-Blockers (n=54) and group two newly administered of Beta-blockers (n=96). The results showed that the percentages of AF cases in group one (n=2, (3.7%) were lower than group two (n=15, (15.6%).The p= 0.027, bradycardia 37/54(68.5%) in group one and 47/96(31.3%) in group two, p=0.000 was in favour of group two. Hypotension was 37/54(68.5%) in group one and 26/96(27.1%) in group two; p= 0.000 wasin favour of group two. CCU length of stay in days 4.00 ± 0.87 in group one and 3.57 ± 1.41 in group two; p= 0.046 was in favour of group two. Hospital length of stay in days was7.85 ± 2.79 in group one and 4.70 ± 2.68 in group two; p=0.000 was in favor of group two. Pain Assessment (VAS) was3.65 ± 0.84 in group one and 4.14 ± 1.16 in group two; p= 0.007 was in favour of group one, Conclusion: A perioperative beta blocker (Bisoprolol) could lower the risk of developing postoperative AF and lessen the intensity of pain following coronary bypass graft surgery. Patients on chronic beta blockers increased the likelihood of hospital and intensive care unit length of stay. Preoperative risk factors for AF include heart failure, and COPD. Keywords: Beta Blocker; Bisoprolol; Postoperative Atrial fibrillation; Coronary Artery Bypass Grafting (CABG); perioperative; length of stay. | |
| dc.identifier.uri | https://hdl.handle.net/20.500.11888/18911 | |
| dc.language.iso | en | |
| dc.supervisor | Dr. Aidah Alkaissi Dr. Moath Nairat | |
| dc.title | INCIDENCE OF POST-OPERATIVE ATRIAL FIBRILLATION IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING SURGERY AFTER GIVING PERIOPERATIVE BETA BLOCKERS:A PROSPECTIVE OBSERVATIONAL STUDY IN A UNIVERSITY HOSPITAL IN PALESTINE | |
| dc.type | Thesis |