scholarly journals Anticoagulation therapy for patients with new-onset post-operative atrial fibrillation after non-cardiac surgery: must do, may do, or don’t do?

2020 ◽  
Author(s):  
P. Timothy Pollak ◽  
L. Brent Mitchell
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Anticoagulation Therapy ◽  
Post Operative Atrial Fibrillation ◽  
New Onset

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 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.

scholarly journals Validation of an algorithm based on administrative data to detect new onset of atrial fibrillation after cardiac surgery

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jonathan Bourgon Labelle ◽  
Paul Farand ◽  
Christian Vincelette ◽  
Myriam Dumont ◽  
Mathilde Le Blanc ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Administrative Data ◽  
New Onset

scholarly journals Obesity and Risk of New-Onset Atrial Fibrillation After Cardiac Surgery

Circulation ◽  
2005 ◽  
Vol 112 (21) ◽  
pp. 3247-3255 ◽  
Author(s):  
Anoar Zacharias ◽  
Thomas A. Schwann ◽  
Christopher J. Riordan ◽  
Samuel J. Durham ◽  
Aamir S. Shah ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Onset Atrial Fibrillation ◽  
New Onset

Contrasting effects of diabetes and metabolic syndrome on post-operative atrial fibrillation and in-hospital outcome after cardiac surgery

2013 ◽  
Vol 167 (5) ◽  
pp. 2347-2350 ◽  
Author(s):  
Christopher Hurt ◽  
Augustin Coisne ◽  
Thomas Modine ◽  
Jean-Louis Edme ◽  
Xavier Marechal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Metabolic Syndrome ◽  
Cardiac Surgery ◽  
Hospital Outcome ◽  
Post Operative Atrial Fibrillation
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