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

Solveig Helgadottir, Martin I. Sigurdsson, Inga L. Ingvarsdottir, David O. Arnar, Tomas Gudbjartsson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

90 Citations (Scopus)

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.

Original languageEnglish
Article number87
JournalJournal of Cardiothoracic Surgery
Volume7
Issue number1
DOIs
Publication statusPublished - 19 Sept 2012

Bibliographical note

Funding Information:
We thank Saemundur Oddsson M.D., Hannes Sigurjonsson M.D., and Sindri Viktorsson B.Sc. for help with data collection, and Gunnhildur Johannsdottir for secretarial help. This study was supported by grants from the Landspitali University Research Fund, the University of Iceland Research Fund, and the Helga Gudmundsdottir and Sigurlidi Kristjansson Memorial Fund.

Other keywords

  • Atrial valve replacement
  • Coronary artery bypass surgery
  • Postoperative atrial fibrillation
  • Prophylaxis
  • Risk assessment
  • Risk factors
  • Survival

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