Atrial fibrillation (AF) is the most frequent arrhythmia, occurring after heart surgery. The incidence of AF in early postoperative period after heart transplantation is about 11%, after coronary artery bypass grafting 25–30%, after correction of valvular pathology – 33–49%, after combined operations – up to 60%. About 95% of cases the initiation of AF falls on the first 6 days after the operation. The emergence of AF is associated with a higher risk of stroke, myocardial infarction, postoperative mortality, longer hospital stays and, therefore, larger economic costs. Postoperative risk factors for AF include inflammation caused by postcardiotomy syndrome and extracorporeal circulation, electrolyte imbalance, an imbalance of fluids, long-term artificial pulmonary ventilation, later discharge from cardiotonic support. Despite numerous studies, pathophysiology of occurrence of AF in the early postoperative period after cardiac operations remains to be elucidated. Nowadays, inflammation, as one of the main risk factors for AF is a reason of a great interest of many researchers. The similarity of time between the peak of occurrence of AF after cardiac operations and activation of the complement system with the release of pro-inflammatory cytokines (3 to 6 days after surgery) implies the presence of inflammatory component in the mechanism of launching of postoperative AF. Because of this hypothesis, the attention of a number of researchers was focused on the studying the effectiveness of drugs with anti-inflammatory properties in prophylaxis of postoperative AF concerning operations on the open heart. In particular, during the last few years the effectiveness of statin therapy is actively studied. Its positive effect is associated with pleiotropic (anti-inflammatory, antioxidant and membrane-stabilizing properties of statins. Its positive effects are associated with pleiotropic (anti-inflammatory, antioxidant and membrane-stabilizing properties of statins. The study ARMYDA-3 (Atorvastatin for Reduction MYocardial Dysrhythmia After cardiac surgery) is the first study in which it was demonstrated that preoperative administration of atorvastatin dose of 40 mg reduced the incidence of AF after cardiac operations. For more powerful evidence base on the effectiveness of statin therapy in prophylaxis of postoperative AF it is necessary to conduct a larger randomized clinical studies for each type of cardiac operations.

Author Name: Bockeria O.L., Akhobekov A.A.

URL: View PDF

Keywords: atrial fibrillation, cardiac surgery, statins

ISSN: 1814-6791

EISSN: 2307-6313

EOI/DOI: 10.15275/annaritmol.2014.1.2

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