Post Cardiac Surgery Atrial Fibrillation
Conditions
Keywords
sympathetic cardiac denervation, post cardiac surgery atrial fibrillation
Brief summary
we compare the effect of cutting heart nerves in one group of patients with open heart surgery and other group without cutting oh development of disturbance of heart beat after surgery
Detailed description
identifying the outcome of sympathetic denervation on postoperative atrial fibrillation post cardiac surgery
Interventions
PROCEDUREcardiac sympathetic denervation
Before CPB initiation or during aortic cross-clamping, surgical denervation will be performed via meticulous blunt and sharp dissection. Target sites include \[e.g., complete transection/resection of the ligament of Marshall, fat pad mobilization at Waterston's groove, and epicardial neural pathway division\].
PROCEDUREStandard open-heart surgery without additional epicardial or fat pad dissection.
Standard open-heart surgery without additional epicardial or fat pad dissection.
Sponsors
Zagazig University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Age ≥18 years scheduled for elective open-heart surgery via median sternotomy (CABG, valve repair/replacement, or combined procedures). \-
Exclusion criteria
* Preoperative permanent pacemaker or ICD. * Emergency surgery, active endocarditis, or severe hemodynamic instability. * Concomitant planned surgical ablation (e.g., Cox-Maze procedure) or left atrial appendage occlusion. * Preoperative use of antiarrhythmic drugs (AADs) other than beta-blockers within 5 half-lives of surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of overall Post operative atrial fibrillation | 7th Post operative day or hospital discharge (whichever comes first). | defined as any telemetry-documented or 12-lead ECG-confirmed episode of atrial fibrillation, atrial flutter, or atrial tachycardia lasting ≥30 continuous seconds through POD 7 or hospital discharge defined as any telemetry-documented or 12-lead ECG-confirmed episode of atrial fibrillation, atrial flutter, or atrial tachycardia lasting ≥30 continuous seconds through POD 7 or hospital discharge (whichever comes first |
| Incidence of persistent Post operative atrial fibrillation | 3 months posoperative | (duration \>24 continuous hours or requiring urgent chemical/electrical cardioversion due to hemodynamic instability). |
Countries
Egypt
Outcome results
None listed