• John G T Augoustides, Wilson Szeto, E Andrew Ochroch, Doreen Cowie, Justin Weiner, Andrew J Gambone, Dawn Pinchasik, and Joseph E Bavaria.
• Department of Anesthesiology and Critical Care, Hospital of University of Pennsylvania, Philadelphia, PA 19104-4283, USA. yiandoc@hotmail.com
• J. Cardiothorac. Vasc. Anesth. 2007 Jun 1;21(3):388-92.

ObjectiveTo delineate the incidence, outcome impact, and clinical predictors of atrial fibrillation (AF) after adult aortic arch repair requiring deep hypothermic circulatory arrest (AAR-DHCA) AIMS: To determine the incidence of AF after AAR-DHCA, to determine whether AF after AAR-DHCA affects mortality or stay in the intensive care unit (ICU), to determine multivariate predictors for AF after AAR-DHCA, and to determine whether aprotinin protects against AF after AAR-DHCA.Study DesignRetrospective and observational.Study SettingSingle large university hospital.ParticipantsAll adults undergoing AAR-DHCA in 2000 and 2001.Main ResultsThe cohort size was 144. Antifibrinolytic exposure was 100%, aprotinin 66% and aminocaproic acid 34%. The incidence of AF was 34.0%. AF was not significantly associated with increased mortality or prolonged ICU stay. Advanced age was a multivariate risk factor for AF. Lower temperature nadir during DHCA was protective against postoperative AF. Aprotinin had no demonstrable effect on AF after AAR-DHCA.ConclusionsAF after AAR-DHCA is common but does not independently increase mortality or ICU stay. The risk of AF after AAR-DHCA increases with age but decreases with the degree of hypothermia during DHCA. Aprotinin does not appear to affect the risk of AF after AAR-DHCA.

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