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. 2012 Sep 19:7:87.
doi: 10.1186/1749-8090-7-87.

Atrial fibrillation following cardiac surgery: risk analysis and long-term survival

Solveig Helgadottir  1 , Martin I Sigurdsson, Inga L Ingvarsdottir, David O Arnar, Tomas Gudbjartsson
Affiliations

Atrial fibrillation following cardiac surgery: risk analysis and long-term survival

Solveig Helgadottir et al. J Cardiothorac Surg. .

Abstract

Background: We studied potential risk factors for postoperative atrial fibrillation (POAF) in a large cohort of patients who underwent open-heart surgery, evaluating short- and long-term outcome, and we developed a risk-assessment model of POAF.

Methods: A retrospective study of 744 patients without prior history of AF who underwent CABG (n = 513), OPCAB (n = 207), and/or AVR (n = 156) at Landspitali Hospital in 2002-2006. Logistic regression analysis was used to study risk factors for POAF, comparing patients with and without POAF.

Results: The rate of POAF was 44%, and was higher following AVR (74%) than after CABG (44%) or OPCAB (35%). In general, patients with POAF were significantly older, were more often female, were less likely to be smokers, had a lower EF, and had a higher EuroSCORE. The use of antiarrythmics was similar in the groups but patients who experienced POAF were less likely to be taking statins. POAF patients also had longer hospital stay, higher rates of complications, and operative mortality (5% vs. 0.7%). In multivariate analysis, AVR (OR 4.4), a preoperative history of cardiac failure (OR 1.8), higher EuroSCORE (OR 1.1), and advanced age (OR 1.1) were independent prognostic factors for POAF. Overall five-year survival was 83% and 93% for patients with and without POAF (p <0.001).

Conclusion: POAF was detected in 44% of patients, which is high compared to other studies. In the future, our assessment score will hopefully be of use in identifying patients at high risk of POAF and lower complications related to POAF.

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Figures

Figure 1
Figure 1
Probability table of POAF. A risk score to evaluate the probability of postoperative fibrillation following CABG/OPCAB or AVR + CABG for patients without any prior history of atrial fibrillation, based on age and standardized EuroSCORE. Probability is reported in percentages.
Figure 2
Figure 2
Survival of patients with POAF and NSR. A Kaplan-Meyer survival curve of patients with POAF and NSR following CABG/OPCAB, AVR, or CABG/OPCAB + AVR surgery in Iceland between 2002 and 2006.
See this image and copyright information in PMC

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