Background: Postoperative atrial fibrillation (POAF) is the most frequent complication of cardiac surgery. Despite clinical and economic implications, ample variability in POAF assessment method and definition exist across studies. We performed a study‐level meta‐analysis to evaluate the influence of POAF assessment method and definition on its incidence and association with clinical outcomes. Methods and Results: A systematic literature search was conducted to identify studies comparing the outcomes of patients with and without POAF after cardiac surgery that also reported POAF assessment method. The primary outcome was POAF incidence. The secondary outcomes were in‐hospital mortality, stroke, intensive care unit length of stay, and postoperative length of stay. Fifty‐nine studies totaling 197 774 patients were included. POAF cumulative incidence was 26% (range: 7.3%–53.1%). There were no differences in POAF incidence among assessment methods (27%, [range: 7.3%–53.1%] for continuous telemetry, 27% [range: 7.9%–50%] for telemetry plus daily ECG, and 19% [range: 7.8%–42.4%] for daily ECG only; P >0.05 for all comparisons). No differences in in‐hospital mortality, stroke, intensive care unit length of stay, and postoperative length of stay were found between assessment methods. No differences in POAF incidence or any other outcomes were found between POAF definitions. Continuous telemetry and telemetry plus daily ECG were associated with higher POAF incidence compared with daily ECG in studies including only patients undergoing isolated coronary artery bypass grafting. Conclusions: POAF incidence after cardiac surgery remains high, and detection rates are variable among studies. POAF incidence and its association with adverse outcomes are not influenced by the assessment method and definition used, except in patients undergoing isolated coronary artery bypass grafting.

Background: Posterior pericardiotomy (PP) has been shown to reduce the incidence of pericardial effusion and postoperative atrial fibrillation (POAF) after cardiac surgery. However, the procedure and the totality of its effects are poorly known in the cardiac surgery community. We performed a study-level meta-analysis of randomized controlled trials (RCTs) to evaluate the impact of PP in cardiac surgery patients.Methods: A systematic literature search was conducted on three medical databases (Ovid MEDLINE, Ovid Embase, Cochrane Library) to identify RCTs reporting outcomes of patients that received a PP or no intervention after cardiac surgery. The primary outcome was the incidence of POAF. Key secondary outcomes were operative mortality, incidence of pericardial and pleural effusion, cardiac tamponade, length of stay (LOS), pulmonary complications, amount of chest drainage, need for intra-aortic balloon pump, and re-exploration for bleeding.Results: Eighteen RCTs totaling 3,531 patients were included. PP was associated with a significantly lower incidence of POAF (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.32–0.64, P < 0.0001), early (OR 0.18, 95% CI 0.10–0.34, P < 0.0001) and late pericardial effusion (incidence rate ratio 0.13, 95% CI 0.06–0.29, P < 0.0001), and cardiac tamponade (risk difference −0.02, 95% CI −0.04 to −0.01, P = 0.001). PP was associated with a higher incidence of pleural effusion (OR 1.42, 95% CI 1.06–1.90, P = 0.02), but not pulmonary complications (OR 0.82, 95% CI 0.56–1.19; P = 0.38). No differences in other outcomes, including operative mortality, were found.Conclusions: PP is a safe and effective intervention that significantly decreases the incidence of POAF and pericardial effusion following cardiac surgery.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=261485, identifier: CRD42021261485.

The cognitive sciences have witnessed a growing interest in cognitive and neural basis of human creativity. Music improvisations constitute an ideal paradigm to study creativity, but the underlying cognitive processes remain poorly understood. In addition, studies on music improvisations using scales other than the major and minor chords are scarce. Middle Eastern Music is characterized by the additional use of microtones, resulting in a tonal–spatial system called Maqam. No EEG correlates have been proposed yet for the eight most commonly used maqams. The Ney, an end-blown flute that is popular and widely used in the Middle East was used by a professional musician to perform 24 improvisations at low, medium, and high tempos. Using the EMOTIV EPOC+, a 14-channel wireless EEG headset, brainwaves were recorded and quantified before and during improvisations. Pairwise comparisons were calculated using IBM-SPSS and a principal component analysis was used to evaluate the variability between the maqams. A significant increase of low frequency bands theta power and alpha power were observed at the frontal left and temporal left area as well as a significant increase in higher frequency bands beta-high bands and gamma at the right temporal and left parietal area. This study reveals the first EEG observations of the eight most commonly used maqam and is proposing EEG signatures for various maqams.