# Calcium-geïnduceerde autonome denervatie bij postoperatief AF

*geplaatst 2021-01-05 · Atriumfibrilleren · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2020.10.049 · https://hartvaat.nl/2021/01/05/calcium-geinduceerde-autonome-denervatie-bij-postoperatief-af/*

Studie naar calcium-geïnduceerde autonome denervatie bij patiënten met postoperatief atriumfibrilleren.

## English: Calcium-Induced Autonomic Denervation in Patients With Post-Operative Atrial Fibrillation.

This study tested calcium-induced autonomic denervation for preventing postoperative atrial fibrillation after cardiac surgery, exploring a targeted autonomic intervention for this common surgical complication.

## Abstract (original, from the publication)

BACKGROUND: Post-operative atrial fibrillation (POAF) is associated with worse long-term cardiovascular outcomes. OBJECTIVES: This study hypothesized that injecting calcium chloride (CaCl2) into the major atrial ganglionated plexi (GPs) during isolated coronary artery bypass grafting (CABG) can reduce the incidence of POAF by calcium-induced autonomic neurotoxicity. METHODS: This proof-of-concept study randomized 200 patients undergoing isolated, off-pump CABG to CaCl2 (n = 100) or sodium chloride (sham, n = 100) injection. Two milliliters of CaCl2 (5%) or sodium chloride (0.9%) was injected into the 4 major atrial GPs during CABG. All patients received 7-day continuous telemetry and Holter monitoring. The primary outcome was incidence of POAF (≥30 s) in 7 days. Secondary outcomes included length of hospitalization, POAF burden, average ventricular rate during AF, plasma level of inflammatory markers, and actionable antiarrhythmic therapy to treat POAF. RESULTS: The POAF incidence was reduced from 36% to 15% (hazard ratio: 0.366; 95% confidence interval: 0.211 to 0.635; p = 0.001). Length of hospitalization did not differ between the 2 groups. POAF burden (first 7 post-operative days), the use of amiodarone or esmolol, and the incidence of atrial couplets and nonsustained atrial tachyarrhythmias were significantly reduced in the CaCl2 group. Heart rate variability data showed a decrease in both high-frequency and low-frequency power in the CaCl2 group with a preserved low-frequency/high-frequency ratio, suggesting that the sympathetic/parasympathetic balance was not perturbed by CaCl2 injection. CONCLUSIONS: Injection of CaCl2 into the 4 major atrial GPs reduced the POAF hazard by 63%. Inhibition of GP function by Ca-mediated neurotoxicity may underlie the therapeutic effect. (Calcium Autonomic Denervation Prevents Postoperative Atrial Fibrillation; ChiCTR1800019276).

Auteurs: Huishan Wang, Yuji Zhang, Fangran Xin, Hui Jiang, Dengshun Tao, Yan Jin, Yuanchen He, Qiang Wang, Sunny S Po

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2020.10.049. Bijgewerkt 2026-07-03T13:28:08Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.