Use of Corticosteroids on Prophylaxis of New-Onset Atrial Fibrillation after Cardiac Surgery

Abstract

M ost cardiac operations are performed under cardiopulmonary bypass(CPB); however, it is well known that cardiopulmonary bypass often causes systemic inflammatory response syndrome (SIRS) (D’Agostino et al., 2018). Cardiac tissue inflammation induced by the CPB and surgical trauma has been previously hypothesized to cause POAF (Liu et al., 2021). The relationship between inflammation and atrial fibrillation after cardiac surgery is further strengthened by studies that showed that corticosteroid (CS) prophylaxis can reduce the occurrence of atrial fibrillation after cardiac surgery (Cappabianca et al., 2011). This study aimed to determine the efficacy of corticosteroids in prophylaxis of POAF and shorten length of intensive care unit (ICU) and hospital stay. This is randomized controlled clinical trial on 84 patients who underwent their first elective cardiac surgery under cardiopulmonary bypass in Ain Shams University Hospitals. Patients were randomized into two equal groups (n = 42 each) as the control group who underwent a standard cardiopulmonary bypass without any additional medication which was performed under the supervision of a specialized elite and experts in their specialization, and the Methylprednisolone (MP) group who was given 1 g of methylprednisolone (divided into 250 mg every 6h once in the ICU), The primary outcome is the overall occurrence of postoperative AF during the first 72 hours after cardiac surgery. Secondary outcomes are the length of hospital stay, and intensive care unit (ICU) stay.