Managing postoperative atrial fibrillation after open-heart surgery using transdermal β1 blockers
Abstract Background Postoperative atrial fibrillation (POAF) after open-heart surgery is a non-negligible complication. We aimed to describe the efficacy of a transdermal patch of bisoprolol for managing POAF and flutter in thoracic surgical procedures. Methods We analyzed the data of 384 patients w...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-04-01
|
| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02227-z |
| _version_ | 1797849890202583040 |
|---|---|
| author | Kenji Yamamoto Senri Miwa Tomoyuki Yamada Shuji Setozaki Mamoru Hamuro Shunji Kurokawa Sakae Enomoto |
| author_facet | Kenji Yamamoto Senri Miwa Tomoyuki Yamada Shuji Setozaki Mamoru Hamuro Shunji Kurokawa Sakae Enomoto |
| author_sort | Kenji Yamamoto |
| collection | DOAJ |
| description | Abstract Background Postoperative atrial fibrillation (POAF) after open-heart surgery is a non-negligible complication. We aimed to describe the efficacy of a transdermal patch of bisoprolol for managing POAF and flutter in thoracic surgical procedures. Methods We analyzed the data of 384 patients who underwent open-heart surgery at our hospital and received oral bisoprolol to prevent POAF. Among them, 65 patients (16.9%) also received a 4-mg transdermal patch of bisoprolol to control the heart rate due to POAF. We applied the bisoprolol transdermal patch when the heart rate was > 80 bpm and removed it at ≤ 60 bpm; an additional patch was applied when the heart rate was > 140 bpm. Heparin calcium injections were administered twice daily for anticoagulation between 2 and 6 days postoperatively. Results The average number of prescriptions for transdermal patches of bisoprolol during hospitalization was 1.8 ± 1.1 (1–5). The median first prescription date was on postoperative day 2 (range: days 0–37). Sinus rhythm recovered within 24 h in 18 patients (27.7%). Eight patients (12.3%) were switched to continuous landiolol infusion because of persistent tachycardia. In three patients, the transdermal patch was removed owing to severe bradycardia. Fifteen patients experienced persistent atrial fibrillation and were treated with electrical cardioversion during hospitalization. We did not observe any serious complications that could be directly attributed to bisoprolol transdermal patch use. Conclusions Single-use bisoprolol transdermal patch may help control the heart rate during the initial treatment of POAF after open-heart surgery. |
| first_indexed | 2024-04-09T18:51:26Z |
| format | Article |
| id | doaj.art-384155dcee3341e59e156e49f7829042 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-09T18:51:26Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-384155dcee3341e59e156e49f78290422023-04-09T11:26:30ZengBMCJournal of Cardiothoracic Surgery1749-80902023-04-011811710.1186/s13019-023-02227-zManaging postoperative atrial fibrillation after open-heart surgery using transdermal β1 blockersKenji Yamamoto0Senri Miwa1Tomoyuki Yamada2Shuji Setozaki3Mamoru Hamuro4Shunji Kurokawa5Sakae Enomoto6Department of Cardiovascular Surgery, Okamura Memorial HospitalDepartment of Cardiovascular Surgery, Okamura Memorial HospitalDepartment of Cardiovascular Surgery, Shiga General HospitalDepartment of Cardiovascular Surgery, Shizuoka General HospitalDepartment of Cardiovascular Surgery, Okamura Memorial HospitalDepartment of Cardiovascular Surgery, Okamura Memorial HospitalDepartment of Cardiovascular Surgery, Okamura Memorial HospitalAbstract Background Postoperative atrial fibrillation (POAF) after open-heart surgery is a non-negligible complication. We aimed to describe the efficacy of a transdermal patch of bisoprolol for managing POAF and flutter in thoracic surgical procedures. Methods We analyzed the data of 384 patients who underwent open-heart surgery at our hospital and received oral bisoprolol to prevent POAF. Among them, 65 patients (16.9%) also received a 4-mg transdermal patch of bisoprolol to control the heart rate due to POAF. We applied the bisoprolol transdermal patch when the heart rate was > 80 bpm and removed it at ≤ 60 bpm; an additional patch was applied when the heart rate was > 140 bpm. Heparin calcium injections were administered twice daily for anticoagulation between 2 and 6 days postoperatively. Results The average number of prescriptions for transdermal patches of bisoprolol during hospitalization was 1.8 ± 1.1 (1–5). The median first prescription date was on postoperative day 2 (range: days 0–37). Sinus rhythm recovered within 24 h in 18 patients (27.7%). Eight patients (12.3%) were switched to continuous landiolol infusion because of persistent tachycardia. In three patients, the transdermal patch was removed owing to severe bradycardia. Fifteen patients experienced persistent atrial fibrillation and were treated with electrical cardioversion during hospitalization. We did not observe any serious complications that could be directly attributed to bisoprolol transdermal patch use. Conclusions Single-use bisoprolol transdermal patch may help control the heart rate during the initial treatment of POAF after open-heart surgery.https://doi.org/10.1186/s13019-023-02227-zbeta-blockersTransdermal patchBisoprololPostoperative atrial fibrillationBisono tape |
| spellingShingle | Kenji Yamamoto Senri Miwa Tomoyuki Yamada Shuji Setozaki Mamoru Hamuro Shunji Kurokawa Sakae Enomoto Managing postoperative atrial fibrillation after open-heart surgery using transdermal β1 blockers Journal of Cardiothoracic Surgery beta-blockers Transdermal patch Bisoprolol Postoperative atrial fibrillation Bisono tape |
| title | Managing postoperative atrial fibrillation after open-heart surgery using transdermal β1 blockers |
| title_full | Managing postoperative atrial fibrillation after open-heart surgery using transdermal β1 blockers |
| title_fullStr | Managing postoperative atrial fibrillation after open-heart surgery using transdermal β1 blockers |
| title_full_unstemmed | Managing postoperative atrial fibrillation after open-heart surgery using transdermal β1 blockers |
| title_short | Managing postoperative atrial fibrillation after open-heart surgery using transdermal β1 blockers |
| title_sort | managing postoperative atrial fibrillation after open heart surgery using transdermal β1 blockers |
| topic | beta-blockers Transdermal patch Bisoprolol Postoperative atrial fibrillation Bisono tape |
| url | https://doi.org/10.1186/s13019-023-02227-z |
| work_keys_str_mv | AT kenjiyamamoto managingpostoperativeatrialfibrillationafteropenheartsurgeryusingtransdermalb1blockers AT senrimiwa managingpostoperativeatrialfibrillationafteropenheartsurgeryusingtransdermalb1blockers AT tomoyukiyamada managingpostoperativeatrialfibrillationafteropenheartsurgeryusingtransdermalb1blockers AT shujisetozaki managingpostoperativeatrialfibrillationafteropenheartsurgeryusingtransdermalb1blockers AT mamoruhamuro managingpostoperativeatrialfibrillationafteropenheartsurgeryusingtransdermalb1blockers AT shunjikurokawa managingpostoperativeatrialfibrillationafteropenheartsurgeryusingtransdermalb1blockers AT sakaeenomoto managingpostoperativeatrialfibrillationafteropenheartsurgeryusingtransdermalb1blockers |