I am writing in regards to the article by Miller and Drew1 on the use of atrial electrograms (AEGs) after cardiac surgery. I was intrigued by the results of the survey, which described the underuse of atrial epicardial wires to diagnose atrial arrhythmias. Working as an advanced registered nurse practitioner in a tertiary care cardiothoracic surgery unit, I have found use of AEGs to be much more prominent here than among those units surveyed.

Our complex patient population includes combined coronary artery bypass grafting and valve surgery, recurrent and multiple valve surgery patients, heart transplant, and ventricular assist device patients bridging to transplant. As recognized by the authors, these populations have an increased risk of atrial arrhythmias.

Our bedside nurses undergo a 16-week orientation in the cardiothoracic intensive care unit. The more experienced nurses mentor the newer staff members in the benefits of AEG and frequently perform an AEG...

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