476 New onset post-operative atrial fibrillation is associated with a long-term risk for stroke following cardiac surgery

2011 ◽  
Vol 27 (5) ◽  
pp. S234-S235
Author(s):  
P. Horwich ◽  
K.J. Buth ◽  
J. Légaré
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Post Operative Atrial Fibrillation ◽  
New Onset

scholarly journals 512 Long-term survival in patients with post-operative atrial fibrillation after cardiac surgery: analysis from a prospective-cohort study

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Jacopo Marazzato ◽  
Roberto De Ponti ◽  
Paolo Verdecchia ◽  
Federico Blasi ◽  
Michele Golino ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Risk Of Mortality ◽  
Post Operative Atrial Fibrillation ◽  
Increased Risk ◽  
All Cause Mortality ◽  
History Of ◽  
New Onset

Abstract Aims Post-operative atrial fibrillation (POP AF) is frequent in patients who undergo cardiac surgery. However, its prognostic impact in the long-term remains unclear. Methods and results We followed for an average of 10 ± 3 years 1386 patients who underwent a variety of cardiac surgical procedures (cardiac transplantation and surgery for heart failure included) while they were in sinus rhythm. Among 1178 patents without a history of AF, 726 (62%) did not develop AF during the entire duration of the study and 452 (38%) developed new-onset POP AF during the first 30 peri-operative days after heart surgery. Other 125 patients with a positive history of paroxysmal or persistent AF were in sinus rhythm at the time of surgery and 87 of them (70%) developed POP AF. Finally, 83 patients had permanent AF when they underwent surgery. All-cause mortality was the primary outcome of the study. We tested the associations of potential determinants with all-cause mortality using univariable and multivariable statistical analyses by means of Cox proportional hazard models. Overall, 473 patients (34%) died during a long-term follow-up. Compared with patients who never developed AF, neither the patients with new-onset POP AF [adjusted HR = 1.31 (95% CI: 0.90–1.89); P = 0.1609], nor those with history of AF at the time of surgery (adjusted HR = 1.33, 95% CI: 0.71–2.49; P = 0.3736) showed a significantly increased risk of mortality (Figure 1). In new-onset POP AF patients, oral anticoagulation was not associated with mortality [adjusted HR = 1.13 (95% CI: 0.83–1.54), P = 0.4299]. Conclusions In this huge prospective cohort of patients who underwent different types of heart surgery, POP AF was not associated with an increased risk of mortality. In this setting, the role of long-term anticoagulation remains unclear.

Abstract 302: Echocardiographic Parameters in Perioperative Atrial Fibrillation in Cardiac and Non-Cardiac Surgery Patients

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Jaspreet Arora ◽  
Arjun Nair ◽  
Leigh Cagino ◽  
Le Du ◽  
Mikhail Torosoff
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Academic Medical Center ◽  
Study Cohort ◽  
Post Operative Atrial Fibrillation ◽  
Increased Risk ◽  
Social Security Death Index ◽  
New Onset

Background: We hypothesized that patients with new onset atrial fibrillation (AFib) following cardiac or non-cardiac surgery have similar echocardiographic features, regardless of the type of surgery. Methods: Study cohort included 4562 consecutive patients without history of atrial fibrillation undergoing general, thoracic or cardiovascular surgeries at a single tertiary academic medical center. Retrospective chart and echocardiogram review was performed. Chi-square, logistic regression, and analysis of variance were performed. Long-term all cause mortality was determined through Social Security Death Index. The study was approved by the institutional IRB. Results: Post-operative AFib was noted in 24% (275/1141) after cardiac surgery, 1.2 % (10/804) after thoracic non-cardiac surgery, and 0.7% (18/2617) after general non-cardiac non-thoracic surgery (p<0.0001). On available echocardiograms, 18% (48/264) had LV dilatation and 38% (98/261) had moderate or severe LV dysfunction. The left atrium was dilated in 53% (139/260). Moderate or severe tricuspid regurgitation was noted in 11% (15/128), mitral regurgitation in 28% (45/16), mitral stenosis in 13% (11/82), aortic insufficiency in 27% (37/135), and aortic stenosis in 63% (19/135). When adjusted for the presence of coronary artery disease, valvular disease, age, and gender, only aortic valve stenosis remained an important independent predictor of post-operative atrial fibrillation in non-cardiac surgery patients, HR=13.9 (95%CI 1.5-132.3, p<0.022). Conclusion: Despite significantly increased prevalence of new onset AFib after cardiac surgery, pre-existing cardiovascular conditions, specifically aortic valve stenosis, confer an increased risk of post-operative atrial fibrillation rather than the procedure itself. Improved resource utilization can be expected if post-operative ECG monitoring is limited to the high risk patients, identifiable during peri-operative screening. Prospective studies of this important subject are needed.

scholarly journals Implications of new-onset atrial fibrillation after cardiac surgery on long-term prognosis: A community-based study

2015 ◽  
Vol 170 (4) ◽  
pp. 659-668 ◽  
Author(s):  
Rowlens M. Melduni ◽  
Hartzell V. Schaff ◽  
Kent R. Bailey ◽  
Stephen S. Cha ◽  
Naser M. Ammash ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Community Based ◽  
Long Term Prognosis ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract 14514: The Incidence and Natural Progression of New Onset Post-Operative Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Marcella Meykler ◽  
Sahar Abdelmoneim ◽  
Emelie Rosenberg ◽  
Bimal Patel ◽  
Bharath Reddy ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Continuous Monitoring ◽  
Natural Progression ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Af Recurrence ◽  
New Onset

Introduction: New onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery that is associated with an increased risk for stroke and all-cause mortality. Long term data on POAF recurrence and anticoagulation remains sparse. We aimed to characterize the natural progression and recurrence of new onset POAF during a long-term follow up post cardiac surgery utilizing continuous event monitoring. Methods: This is a single-center, prospective observational study evaluating 42 patients undergoing cardiac surgery and diagnosed during indexed admission with new onset, transient POAF who were discharged in sinus rhythm between May 2015 and December 2019. Prior to discharge, all patients received implantable loop recorders (ILR) for continuous monitoring. Study outcomes were the presence and timing of AF recurrence (first and repeated AF recurrence), all-cause mortality and cerebrovascular accidents (CVA). Results: Forty-two patients [mean age 67.6± 9.6 years, 74% male, mean CHADS 2- VASc 3.5±1.5] were evaluated during a mean follow-up of 1.7 ± 1.2 years. AF recurrence after discharge occurred in 30 patients (71%). Twenty-four of these 30 patients (80%) had their first AF recurrence within the first month, 3 (10%) patients during months 1-12, and 3 (10%) patients beyond 1 year. Repeated AF recurrence occurred in 13 (43%) patients between 1 and 12-months. Beyond one year of follow-up, 5 (17%) patients had either their first AF recurrence (3) or repeated AF recurrence (2). During follow-up, there was one death ((-) AF recurrence) and two CVAs ((+) AF recurrence). Conclusions: In this study of continuous monitoring with ILR , the recurrence of AF in patients who develop transient POAF is common. Seventy percent of patients had either their first AF recurrence 6 (20%) or repeated episodes of recurrent AF 15 (50%) after 1-month post-operative follow-up.

scholarly journals New-onset postoperative atrial fibrillation is associated with worse long-term outcome in critically ill patients after non-cardiac surgery: 3-year follow-up of a case-control study

2019 ◽  
Author(s):  
Min Xie ◽  
Shuang-Ling Li ◽  
Jia-Xin Pan ◽  
Sai-Nan Zhu ◽  
Dong-Xin Wang
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Long Term Outcomes ◽  
Control Study ◽  
New Onset

Abstract Background The impact of new-onset postoperative atrial fibrillation (POAF) on long-term outcomes of patients after non-cardiac surgery remains controversial. Here we report the 3-year follow-up of a previous case-control study to determine the relationship between new-onset POAF and long-term outcomes in patients after non-cardiac surgery. Methods In a previous case-control study, 213 patients who were admitted to the intensive care unit (ICU) after non-cardiac surgery were included; of them 71 were in the POAF group and 142 the control group. A telephone interview was performed with patients or their family members at 3 years after surgery. The primary endpoint was the incidence of major adverse cardiovascular events (MACEs) within 3 years, including cardiovascular death, non-fatal cardiac arrest, acute myocardial infarction, congestive heart failure, and ischemic stroke. A logistic regression model was established to assess the association between the occurrence of new-onset POAF and the development of 3-year MACEs. Results 202 patients completed the 3-year follow-up and were included in the analysis; of them 68 were in the POAF group and 134 were in the control group. The incidence of 3-year MACEs was higher in the POAF group than in the control group (64.7% [44/68] vs. 23.1% [31/134], p<0.001). After correction for confounding factors, new-onset POAF was independently associated with an increased risk of 3-year MACEs (odds ratio 5.448, 95% confidence interval 2.202-13.481, p<0.001). Conclusions For adult patients admitted to the ICU after non-cardiac surgery, new-onset POAF was an independent risk factor for the development of MACEs within 3 years.

scholarly journals Low Embolic Risk from Short Duration Atrial Fibrillation following Anatomic Lung Resection

2021 ◽  
Vol 9 (1) ◽  
pp. 72-77
Author(s):  
Boxiang Jiang ◽  
Philip Linden ◽  
Alejandro Oliu ◽  
Christopher Towe ◽  
Yaron Perry ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Short Duration ◽  
Lung Resection ◽  
Single Institution ◽  
Post Operative Atrial Fibrillation ◽  
Anatomic Lung Resection ◽  
Embolic Risk ◽  
New Onset

Objectives There is no consensus regarding the merits of anticoagulation following short duration atrial arrhythmia and anatomic lung resection. We hypothesized that the risk of embolic event following episodes of atrial fibrillation (AF) lasting less than 48 hours is low and even with an elevated CHA2DS2-VASC score should not incur the risk of long-term full dose anticoagulation contrary to recommendations. Design & Intervention A retrospective review was performed of a prospectively maintained database of all patients undergoing anatomic lung resection at a single institution from 2014 to 2019. Patients who had new onset post-operative atrial fibrillation (POAF) were queried as to their co-morbidities, the length of arrhythmia, discharge with anticoagulation, and any post-operative embolic events. Main Outcome Measures There were 565 patients who underwent anatomic lung resection. 40 patients (7.1%) developed new POAF that lasted a median of one day. In 32 patients (80%), POAF lasted for less than 48 hours. There were 28 males and 12 females, median age of 73 years. These patients underwent segmentectomy (2/40), lobectomy (24/40) and pneumonectomy (14/40). Twenty-nine patients were discharged home without anticoagulation. Median follow-up was 22 month (range 1.3 – 62.8 month). Two patients had embolic events and these two were discharged home without anticoagulation. The overall incidence rate of thromboembolic events was 3.2% per person year. Conclusions Our data suggest that the risk of arterial embolic events is low in patients with new, short duration atrial fibrillation post anatomical lung resection. Anticoagulation may not be necessary in these patients and can be given selectively.

2225“New-onset atrial fibrillation efter cardiac surgery is associated with increased long-term morbidity and mortality”: a population-based study from the SWEDEHEART-registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Taha ◽  
A Jeppsson ◽  
L Friberg ◽  
S Nielsen ◽  
A Ahlsson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Population Based ◽  
Long Term Outcome ◽  
Increased Risk ◽  
Cabg Patients ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Background New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, but the prognostic implications are not settled. In contrast to previous reports, a recent Danish study in coronary bypass surgery (CABG) patients (Butt et al. JAMA Cardiol 2018) did not show any increased risk for thromboembolic complications in POAF patients. Purpose To compare long-term outcome in patients with vs. without POAF after CABG. Methods All CABG patients in Sweden 2005–2015 (n=38040) were included in a retrospective population-based cohort study. Data from the SWEDEHEART registry, the National Patient Registry and the National Population Registry were merged. POAF was defined as any new-onset atrial fibrillation (AF) episode up to the 30thpostoperative day. Inverse Probability Treatment Weighting (IPTW) adjusted Cox regression models were used to compare outcome variables after the first 30 postoperative days until the end of follow-up (median 5 years, range 0–10). The models were adjusted for age, gender, CHA2DS2-VASc score, co-morbidity, and medications. Results The mean age of the entire cohort was 68 years, 79% were men and 90% had a CHA2DS2-VASc score ≥2. The incidence of POAF was 28.5% (10845/38040). During follow-up POAF, patients had a significantly higher adjusted risk for all-cause mortality [Hazard Ratio (HR) 1.16 (95% CI 1.09–1.24)], ischemic stroke [HR 1.19 (1.09–1.30)], transient ischemic attack [HR 1.17 (1.03–1.33)], pulmonary embolism [HR 1.24 (1.01–1.54)], myocardial infarction [HR 1.14 (1.04–1.25)], heart failure hospitalizations [HR.1.46 (1.35–1.59)] and recurrent AF [HR 4.33 (4.09–4.65)]. Conclusions POAF was in this comparatively large study associated with increased risk for mortality and morbidity during long-term follow-up after CABG and is hence not a trivial complication.

Sign in / Sign up

Export Citation Format

Share Document