New-onset atrial fibrillation after CABG
Conditions
Interventions
Control group:Coronary Artery Bypass Grafting (CABG)
Test group:Concomitant left atrial appendage clip closure during coronary artery bypass grafting
Sponsors
West China Hospital of Sichuan University
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1. Aged 18-75 years, regardless of gender; 2. Preoperative sinus rhythm confirmed by electrocardiogram or Holter monitoring; 3. Meets the indications for CABG surgery (according to the 2023 ESC Guidelines for the Management of Coronary Artery Disease); 4. CHA2DS2-VASc score >= 2; 5. Preoperative cardiac ultrasound indicates a left atrial appendage volume 50 ml may have suboptimal closure outcomes and are excluded); 6. American Society of Anesthesiologists (ASA) classification II-III (patients with ASA IV are excluded due to excessively high surgical risk); 7. The patient and their family have been informed and provided signed informed consent, agreeing to complete a 1-year follow-up.
Exclusion criteria
Exclusion criteria: 1. History of prior cardiac surgery; 2. Preoperative history of atrial fibrillation (including paroxysmal, persistent, or permanent AF) or preoperative Holter monitoring indicating an AF burden > 5%; 3. Preoperative diagnosis of stroke (including ischemic or hemorrhagic stroke) or transient ischemic attack (TIA); 4. Structural abnormalities of the left atrial appendage (e.g., LAA thrombus, LAA malformation, LAA diverticulum); 5. Severe cardiac dysfunction (left ventricular ejection fraction 265 µmol/L); 7. Coagulation disorders (prothrombin time > 16 seconds, activated partial thromboplastin time > 45 seconds, platelet count < 100 × 10?/L); 8. Malignant tumor (life expectancy < 1 year); 9. Psychiatric or cognitive impairment, unable to cooperate with follow-up; 10. Allergy to materials used in the left atrial appendage clip (e.g., titanium alloy);
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| postoperative atrial fibrillation, POAF; | — |
Secondary
| Measure | Time frame |
|---|---|
| Length of postoperative hospital stay;1-year cardiovascular readmission rate;Incidence of grade >=3 adverse events within 30 days after surgery and incidence of grade >=4 adverse events during the 2-year follow-up period.;Cerebrovascular accident (CVA); | — |
Countries
China
Contacts
Public ContactZhenghua Xiao
West China Hospital of Sichuan University
Outcome results
None listed