Anhthi H. Luong BA , S. Kendall Smith MD, PhD , Karishma Bhatia MD , MohammedMehdi Kafashan PhD , Thomas Nguyen BS , Orlandrea Hyche BS , Matthew Schill MD , Ralph J. Damiano Jr. MD , Ben Julian A. Palanca MD, PhD
{"title":"心脏外科患者术后新发心房颤动与术前睡眠","authors":"Anhthi H. Luong BA , S. Kendall Smith MD, PhD , Karishma Bhatia MD , MohammedMehdi Kafashan PhD , Thomas Nguyen BS , Orlandrea Hyche BS , Matthew Schill MD , Ralph J. Damiano Jr. MD , Ben Julian A. Palanca MD, PhD","doi":"10.1016/j.atssr.2024.07.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>New-onset postoperative atrial fibrillation is associated with adverse clinical outcomes in older adults. Poor preoperative sleep quality is a putative modifiable risk factor. The relationships between new-onset postoperative atrial fibrillation and preoperative sleep structure in older adults undergoing elective cardiac surgery were investigated at a single center.</div></div><div><h3>Methods</h3><div>This was a prespecified substudy within a prospective observational study of perioperative electroencephalographic markers (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; <span><span>NCT03291626</span><svg><path></path></svg></span>). We analyzed preoperative sleep recordings from 71 cardiac surgical patients aged ≥60 years without a prior history of atrial fibrillation. Overnight recordings were acquired using a consumer-grade headband and underwent manual sleep staging. Electroencephalographic slow wave activity (power in the 0.5-4 Hz frequency band) was computed in 1-minute intervals for non-rapid eye movement sleep stages. Associations between new-onset postoperative atrial fibrillation incidence and sleep measures were evaluated using univariate logistic regression models and multivariate logistic regression models including age and sex.</div></div><div><h3>Results</h3><div>New-onset postoperative atrial fibrillation was present in 22 of 71 (31%) patients. A higher preoperative percentage of total sleep time in non-rapid eye movement stage 1 was associated with new-onset postoperative atrial fibrillation (median difference of 5.4%, <em>P</em> = .0002, Mann-Whitney U-test), independent of age and sex. No associations were observed between new-onset postoperative atrial fibrillation and other sleep metrics, including slow wave activity (all <em>P</em> > .05, Mann-Whitney U-test).</div></div><div><h3>Conclusions</h3><div>Excess preoperative non-rapid eye movement stage 1 sleep, consistent with greater sleep fragmentation, is a potential modifiable target for mitigating new-onset postoperative atrial fibrillation risk in older adults undergoing elective cardiac surgery requiring cardiopulmonary bypass.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 258-263"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"New-Onset Postoperative Atrial Fibrillation and Preoperative Sleep in Cardiac Surgical Patients\",\"authors\":\"Anhthi H. Luong BA , S. Kendall Smith MD, PhD , Karishma Bhatia MD , MohammedMehdi Kafashan PhD , Thomas Nguyen BS , Orlandrea Hyche BS , Matthew Schill MD , Ralph J. Damiano Jr. MD , Ben Julian A. Palanca MD, PhD\",\"doi\":\"10.1016/j.atssr.2024.07.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>New-onset postoperative atrial fibrillation is associated with adverse clinical outcomes in older adults. Poor preoperative sleep quality is a putative modifiable risk factor. The relationships between new-onset postoperative atrial fibrillation and preoperative sleep structure in older adults undergoing elective cardiac surgery were investigated at a single center.</div></div><div><h3>Methods</h3><div>This was a prespecified substudy within a prospective observational study of perioperative electroencephalographic markers (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; <span><span>NCT03291626</span><svg><path></path></svg></span>). We analyzed preoperative sleep recordings from 71 cardiac surgical patients aged ≥60 years without a prior history of atrial fibrillation. Overnight recordings were acquired using a consumer-grade headband and underwent manual sleep staging. Electroencephalographic slow wave activity (power in the 0.5-4 Hz frequency band) was computed in 1-minute intervals for non-rapid eye movement sleep stages. Associations between new-onset postoperative atrial fibrillation incidence and sleep measures were evaluated using univariate logistic regression models and multivariate logistic regression models including age and sex.</div></div><div><h3>Results</h3><div>New-onset postoperative atrial fibrillation was present in 22 of 71 (31%) patients. A higher preoperative percentage of total sleep time in non-rapid eye movement stage 1 was associated with new-onset postoperative atrial fibrillation (median difference of 5.4%, <em>P</em> = .0002, Mann-Whitney U-test), independent of age and sex. No associations were observed between new-onset postoperative atrial fibrillation and other sleep metrics, including slow wave activity (all <em>P</em> > .05, Mann-Whitney U-test).</div></div><div><h3>Conclusions</h3><div>Excess preoperative non-rapid eye movement stage 1 sleep, consistent with greater sleep fragmentation, is a potential modifiable target for mitigating new-onset postoperative atrial fibrillation risk in older adults undergoing elective cardiac surgery requiring cardiopulmonary bypass.</div></div>\",\"PeriodicalId\":72234,\"journal\":{\"name\":\"Annals of thoracic surgery short reports\",\"volume\":\"3 1\",\"pages\":\"Pages 258-263\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of thoracic surgery short reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S277299312400322X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of thoracic surgery short reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S277299312400322X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
New-Onset Postoperative Atrial Fibrillation and Preoperative Sleep in Cardiac Surgical Patients
Background
New-onset postoperative atrial fibrillation is associated with adverse clinical outcomes in older adults. Poor preoperative sleep quality is a putative modifiable risk factor. The relationships between new-onset postoperative atrial fibrillation and preoperative sleep structure in older adults undergoing elective cardiac surgery were investigated at a single center.
Methods
This was a prespecified substudy within a prospective observational study of perioperative electroencephalographic markers (ClinicalTrials.gov; NCT03291626). We analyzed preoperative sleep recordings from 71 cardiac surgical patients aged ≥60 years without a prior history of atrial fibrillation. Overnight recordings were acquired using a consumer-grade headband and underwent manual sleep staging. Electroencephalographic slow wave activity (power in the 0.5-4 Hz frequency band) was computed in 1-minute intervals for non-rapid eye movement sleep stages. Associations between new-onset postoperative atrial fibrillation incidence and sleep measures were evaluated using univariate logistic regression models and multivariate logistic regression models including age and sex.
Results
New-onset postoperative atrial fibrillation was present in 22 of 71 (31%) patients. A higher preoperative percentage of total sleep time in non-rapid eye movement stage 1 was associated with new-onset postoperative atrial fibrillation (median difference of 5.4%, P = .0002, Mann-Whitney U-test), independent of age and sex. No associations were observed between new-onset postoperative atrial fibrillation and other sleep metrics, including slow wave activity (all P > .05, Mann-Whitney U-test).
Conclusions
Excess preoperative non-rapid eye movement stage 1 sleep, consistent with greater sleep fragmentation, is a potential modifiable target for mitigating new-onset postoperative atrial fibrillation risk in older adults undergoing elective cardiac surgery requiring cardiopulmonary bypass.
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