TY - JOUR
T1 - Postacute rehabilitation after coronary surgery
T2 - The effect of preoperative physical activity on the incidence of paroxysmal atrial fibrillation
AU - Giaccardi, Marzia
AU - MacChi, Claudio
AU - Colella, Andrea
AU - Polcaro, Paola
AU - Zipoli, Renato
AU - Cecchi, Francesca
AU - Valecchi, Debora
AU - Sofi, Francesco
AU - Petrilli, Mario
AU - Molino-Lova, Raffaele
PY - 2011/4
Y1 - 2011/4
N2 - Objective: Postoperative atrial fibrillation (AF) is a frequent complication after cardiac surgery. AF may also occur after hospital discharge during postacute rehabilitation. Several studies have addressed the AF that occurs in the hospital after surgery, and predictors have already been identified. Postoperative AF that occurs after hospital discharge has not been investigated thoroughly, and predictors are still unknown. In this study, we hypothesized that moderate-intensity physical activity in the year before surgery might favorably affect the incidence of AF during postacute rehabilitation. Design: We tested our hypothesis in a cohort of 158 older patients admitted to a medical rehabilitation facility for postacute inpatient rehabilitation after coronary surgery and continuously monitored by telemetry for the duration of the rehabilitation. Results: Independent of potential confounders, patients who reported low-intensity physical activity in the year before surgery showed a significantly higher incidence of AF during postacute rehabilitation when compared with those who reported moderate-intensity physical activity (32.1% vs. 8.1%; P = 0.029). Other independent predictors of AF during postacute rehabilitation were the occurrence of AF during the patients' stay in hospital, larger left atrial volume, and lower left atrial emptying fraction. Conclusions: These findings confirm our hypothesis that physical activity in the year before surgery affects the incidence of postoperative AF during postacute rehabilitation. The results also provide information regarding possible predictors that may assist in identifying patients who could benefit from preventive treatments.
AB - Objective: Postoperative atrial fibrillation (AF) is a frequent complication after cardiac surgery. AF may also occur after hospital discharge during postacute rehabilitation. Several studies have addressed the AF that occurs in the hospital after surgery, and predictors have already been identified. Postoperative AF that occurs after hospital discharge has not been investigated thoroughly, and predictors are still unknown. In this study, we hypothesized that moderate-intensity physical activity in the year before surgery might favorably affect the incidence of AF during postacute rehabilitation. Design: We tested our hypothesis in a cohort of 158 older patients admitted to a medical rehabilitation facility for postacute inpatient rehabilitation after coronary surgery and continuously monitored by telemetry for the duration of the rehabilitation. Results: Independent of potential confounders, patients who reported low-intensity physical activity in the year before surgery showed a significantly higher incidence of AF during postacute rehabilitation when compared with those who reported moderate-intensity physical activity (32.1% vs. 8.1%; P = 0.029). Other independent predictors of AF during postacute rehabilitation were the occurrence of AF during the patients' stay in hospital, larger left atrial volume, and lower left atrial emptying fraction. Conclusions: These findings confirm our hypothesis that physical activity in the year before surgery affects the incidence of postoperative AF during postacute rehabilitation. The results also provide information regarding possible predictors that may assist in identifying patients who could benefit from preventive treatments.
KW - Atrial Fibrillation
KW - Cardiac Surgery
KW - Older Persons
KW - Rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=79953007336&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79953007336&partnerID=8YFLogxK
U2 - 10.1097/PHM.0b013e31820f9535
DO - 10.1097/PHM.0b013e31820f9535
M3 - Article
C2 - 21765246
AN - SCOPUS:79953007336
VL - 90
SP - 308
EP - 315
JO - American Journal of Physical Medicine and Rehabilitation
JF - American Journal of Physical Medicine and Rehabilitation
SN - 0894-9115
IS - 4
ER -