scholarly journals Postoperative Atrial Fibrillation in Liver Transplantation

2015 ◽  
Vol 15 (3) ◽  
pp. 687-694 ◽  
Author(s):  
V. W. Xia ◽  
A. Worapot ◽  
S. Huang ◽  
A. Dhillon ◽  
V. Gudzenko ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Liver Transplantation ◽  
Postoperative Atrial Fibrillation

Postoperative Atrial Fibrillation and Cardiac Complications After Liver Transplantation

2018 ◽  
Vol 27 ◽  
pp. S337
Author(s):  
M. Omair ◽  
H. Salehi ◽  
R. Jones ◽  
M. Ord ◽  
P. Calafiore ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Liver Transplantation ◽  
Postoperative Atrial Fibrillation ◽  
Cardiac Complications

scholarly journals Postoperative Atrial Fibrillation and Long-Term Risk of Stroke in Patients Undergoing Liver Transplantation

Stroke ◽  
2021 ◽  
Vol 52 (1) ◽  
pp. 111-120
Author(s):  
Anoop N. Koshy ◽  
Anees Enyati ◽  
Laurence Weinberg ◽  
Hui-Chen Han ◽  
Mark Horrigan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Liver Transplantation ◽  
Independent Predictor ◽  
Hazard Ratio ◽  
Postoperative Atrial Fibrillation ◽  
Prior History ◽  
Thromboembolic Events ◽  
Systemic Embolism ◽  
Increased Risk

Background and Purpose: Postoperative atrial fibrillation (POAF) is the commonest cardiovascular complication following liver transplantation (LT). This study sought to assess a possible association of POAF with subsequent thromboembolic events in patients undergoing LT. Methods: A retrospective cohort study of consecutive adults undergoing LT between 2010 and 2018 was undertaken. Patients were classified as POAF if atrial fibrillation (AF) was documented within 30 days of LT without a prior history of AF. Cases of ischemic stroke or systemic embolism were adjudicated by a panel of 2 independent physicians. Results: Among the 461 patients included, POAF occurred in 47 (10.2%) a median of 3 days following transplantation. Independent predictors of POAF included advancing age, postoperative sepsis and left atrial enlargement. Over a median follow-up of 4.9 (interquartile range, 2.9–7.2) years, 21 cases of stroke and systemic embolism occurred. Rates of thromboembolic events were significantly higher in patients with POAF (17.0% versus 3.1%; P <0.001). After adjustment, POAF remained a strong independent predictor of thromboembolic events (hazard ratio, 8.36 [95% CI, 2.34–29.79]). Increasing CHA 2 DS 2 VASc score was also an independent predictor of thromboembolic events (hazard ratio, 1.58 [95% CI, 1.02–2.46]). A model using POAF and a CHA 2 DS 2 VASc score ≥2 alone yielded a C statistic of 0.77, with appropriate calibration for the prediction of thromboembolic events. However, POAF was not an independent predictor of long-term mortality. Conclusions: POAF following LT is associated with an 8-fold increased risk of thromboembolic events and the use of the CHA 2 DS 2 VASc score may facilitate risk stratification of these patients. Prospective studies are warranted to assess whether the use of oral anticoagulants can reduce the risk of thromboembolism following LT.

scholarly journals Subacute postoperative atrial fibrillation after heart surgery: incidence and predictive factors in cardiac rehabilitation

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
V Rizza ◽  
F Maranta ◽  
L Cianfanelli ◽  
R Grippo ◽  
C Meloni ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Hospital Stay ◽  
Heart Surgery ◽  
Troponin T ◽  
Management Strategies ◽  
Inpatient Rehabilitation ◽  
Postoperative Atrial Fibrillation ◽  
Funding Sources ◽  
Valvular Surgery

Abstract Funding Acknowledgements Type of funding sources: None. Background. Postoperative atrial fibrillation (POAF) is the most common arrhythmic complication following cardiac surgery. It may occur between the second and fourth postoperative days as acute POAF, or within 30 days as subacute POAF (sPOAF). The incidence varies from 15% to 60%, with the highest rates observed in patients undergoing valvular surgery. POAF is associated with longer hospital stay and higher thromboembolic risk, which consistently increase patients’ morbidity and mortality. Identification of high-risk categories may allow optimization of in-hospital prevention and treatment, possibly improving clinical outcomes. Aim of the study. The aim of this study was to assess the incidence of sPOAF and to identify possible predictors in patients performing Cardiovascular Rehabilitation (CR) after Cardiac Surgery (CS). Methods. A single-centre retrospective study was performed on 383 post-cardiac surgery patients hospitalised in our CR Unit for inpatient rehabilitation. The entire population was on sinus rhythm at the admission in CR and continuous monitoring with 12-lead ECG telemetry was performed during the hospital stay. We calculated the incidence of sPOAF and then evaluated the predictive value of the following variables: anamnestic data, type of cardiac intervention, clinical course in both CS and CR Unit, laboratory parameters including baseline neutrophil-to-lymphocyte ratio (NLR). Results. Median age was 65 years (63% male). sPOAF was documented in 122 cases (31.9%). Patients developing sPOAF were older [median age 69 (63-76) vs. 61 (51-70); p &lt; 0.001)], more frequently underwent complex surgical procedures (50% vs. 36%; p = 0.009) and were known for previous episodes of atrial fibrillation (27.9% vs. 11.2%; p &lt; 0.001). On the first day after surgery (T1), sPOAF group showed higher values of glycemia [median 155 (126.5–186.8) vs. 129 (106.5–164); p &lt; 0.001] and troponin T [median 721.5 (470.1–1084.3) vs. 488 (301.6-776.2); p &lt; 0.001]. The multivariate analysis identified advanced age (OR 1.04, 95% CI 1.01-1.08; p = 0.023), acute POAF in the Cardiac Surgery Unit (OR 3.51, 95% CI 1.62-7.59; p = 0.001), baseline NLR (OR 1.46, 95% CI 1.10-1.93; p = 0.008) and T1-troponin &gt; 552 ng/L (OR 4.16 95% CI 1.50-11.53; p = 0.006) as independent risk predictors of sPOAF during the CR period. Conclusions. sPOAF is common after cardiac surgery occurring in 31.9% of patients during CR. Age, acute POAF, baseline NLR and elevated troponin T on the first postoperative day were shown predictors of increased sPOAF risk. Recognition of new predictors of POAF could be helpful to better stratify patients, improving management strategies and outcomes.

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