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Reduced incidence of atrial fibrillation after cardiac surgery by continuous wireless monitoring of oxygen saturation on the normal ward and resultant oxygen therapy for hypoxia


Kisner, D; Wilhelm, M J; Messerli, M S; Zünd, G; Genoni, M (2009). Reduced incidence of atrial fibrillation after cardiac surgery by continuous wireless monitoring of oxygen saturation on the normal ward and resultant oxygen therapy for hypoxia. European Journal of Cardio-Thoracic Surgery, 35(1):111-115.

Abstract

OBJECTIVE: Monitoring of cardiac surgical patients after transfer from the intensive care unit to the normal ward is incomplete. Undetected hypoxia, however, is known to be a risk factor for occurrence of atrial fibrillation. We have utilized Auricall for continuous wireless monitoring of oxygen saturation and heart rate until discharge. The object of the study was to analyze if oxygen therapy as a result of Auricall alerts of hypoxia can decrease the incidence of postoperative atrial fibrillation. METHODS: Auricall is a wireless portable pulse oximeter. An alert is generated depending on preset threshold values (heart rate, oxygen saturation). Over a period of 6 months, 119 patients were monitored with the Auricall following coronary artery bypass graft and/or valve surgery. Oxygen therapy was started subsequent to an oxygen saturation below 90%. These patients were compared with a cohort of 238 patients from the time period before availability of Auricall. The patient characteristics were comparable in both groups. In a retrospective study, the incidence of atrial fibrillation was measured in both groups. RESULTS: The postoperative AF was observed in 22/119 patients (18%) in group I and in 66/238 patients (28%) in group II. This difference between the two groups approached significance (p=0.056). In the subgroup of patients with coronary artery bypass graft with our without simultaneous valve surgery (n=312), Auricall monitoring resulted in a significantly reduced incidence of atrial fibrillation (14% vs 26%, p=0.016). CONCLUSIONS: Continuous monitoring of oxygen saturation on the normal ward and subsequent oxygen therapy for hypoxia can reduce the incidence of atrial fibrillation in a subgroup of patients after cardiac surgery. Prospective randomized trials are warranted to confirm these data.

Abstract

OBJECTIVE: Monitoring of cardiac surgical patients after transfer from the intensive care unit to the normal ward is incomplete. Undetected hypoxia, however, is known to be a risk factor for occurrence of atrial fibrillation. We have utilized Auricall for continuous wireless monitoring of oxygen saturation and heart rate until discharge. The object of the study was to analyze if oxygen therapy as a result of Auricall alerts of hypoxia can decrease the incidence of postoperative atrial fibrillation. METHODS: Auricall is a wireless portable pulse oximeter. An alert is generated depending on preset threshold values (heart rate, oxygen saturation). Over a period of 6 months, 119 patients were monitored with the Auricall following coronary artery bypass graft and/or valve surgery. Oxygen therapy was started subsequent to an oxygen saturation below 90%. These patients were compared with a cohort of 238 patients from the time period before availability of Auricall. The patient characteristics were comparable in both groups. In a retrospective study, the incidence of atrial fibrillation was measured in both groups. RESULTS: The postoperative AF was observed in 22/119 patients (18%) in group I and in 66/238 patients (28%) in group II. This difference between the two groups approached significance (p=0.056). In the subgroup of patients with coronary artery bypass graft with our without simultaneous valve surgery (n=312), Auricall monitoring resulted in a significantly reduced incidence of atrial fibrillation (14% vs 26%, p=0.016). CONCLUSIONS: Continuous monitoring of oxygen saturation on the normal ward and subsequent oxygen therapy for hypoxia can reduce the incidence of atrial fibrillation in a subgroup of patients after cardiac surgery. Prospective randomized trials are warranted to confirm these data.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:12 Mar 2009 07:37
Last Modified:05 Apr 2016 13:10
Publisher:Elsevier
ISSN:1010-7940
Publisher DOI:https://doi.org/10.1016/j.ejcts.2008.08.015
PubMed ID:18835783

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