Valvular & structural heart disease
Cardiovascular Disease-Specific Responses to Autonomic Denervation
Authors' conclusion
Calcium-mediated autonomic denervation did not uniformly prevent POAF across all cardiac surgeries, with an increased incidence observed in the MV surgery group, highlighting the need for disease-specific strategies to prevent POAF. (Calcium Autonomic Denervation Prevents Postoperative Atrial Fibrillation in Patients Undergoing Isolated Mitral Valve Surgery for Mitral Regurgitation [CAP-AF2]; ChiCTR2000029314; Calcium Autonomic Denervation Prevents Postoperative Atrial Fibrillation in Patients Undergoing Isolated Aortic Valve Surgery [CAP-AF3]; ChiCTR2000029313).
Study context
- Population
- Patients undergoing isolated mitral valve surgery for mitral regurgitation (CAP-AF2) or isolated aortic valve surgery (CAP-AF3)CAP-AF2 (enrolled) 160 · CAP-AF3 (randomized) 239
- Comparison
- 5% CaCl2 vs 0.9% NaCl injections into the atrial ganglionated plexi
- Primary endpoint
- Incidence of POAF ≥30 seconds
- Follow-up
- Within 7 days after surgery
Primary result
As reported in the abstract
Postoperative atrial fibrillation (POAF) incidence
55.13% vs 37.80%
P = 0.028
CAP-AF2 (mitral valve (MV) surgery), mid-term analysis; significant increase in the CaCl2 group
POAF incidence
35.59% vs 39.67%
P = 0.516
CAP-AF3 (aortic valve surgery), final analysis; no significant difference
Secondary outcomes
Postoperative hospital stay, AF burden, antiarrhythmic therapy for POAF, plasma levels of inflammatory markers
- Not different between the 2 groups in both trials
Immunohistochemical analyses
- Parasympathetic predominance at the tissue level in patients receiving MV surgery
Original publication
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