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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, Dilek ; Wilhelm, Markus J. ; Messerli, Michael S. ; Zünd, Gregor ; Genoni, Michele

In: European Journal of Cardio-Thoracic Surgery, 2009, vol. 35, no. 1, p. 111-115

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    Title
    • 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
    Author
    • Kisner, Dilek. Clinic for Cardiovascular Surgery, University Hospital Zurich, Rämistr. 100, Zurich CH-8091, Switzerland
    • Wilhelm, Markus J.. Clinic for Cardiovascular Surgery, University Hospital Zurich, Rämistr. 100, Zurich CH-8091, Switzerland
    • Messerli, Michael S.. Clinic for Cardiovascular Surgery, University Hospital Zurich, Rämistr. 100, Zurich CH-8091, Switzerland
    • Zünd, Gregor. Department of Experimental Surgery, University Hospital Zurich, Zurich, Switzerland
    • Genoni, Michele. Clinic for Cardiovascular Surgery, University Hospital Zurich, Rämistr. 100, Zurich CH-8091, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • European Journal of Cardio-Thoracic Surgery, 2009, vol. 35, no. 1, p. 111-115. Elsevier Science B.V.
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:293577
    Summary
    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