Continuous monitoring with implantable loop recorders detected late postoperative atrial fibrillation in 47% of patients without prior AF during 36 months after cardiac surgery.
Cohort (n=79)
Nearly half of patients without prior atrial fibrillation develop late postoperative atrial fibrillation after cardiac surgery, which can be predicted by early postoperative atrial fibrillation, advanced age, larger right atrial volume, and prolonged PR time.
AIMS: Postoperative atrial fibrillation (POAF) after cardiac surgery is an independent predictor of stroke and mortality late after discharge. We aimed to determine the burden and predictors of early (up to 5th postoperative day) and late (after 5th postoperative day) new-onset atrial fibrillation (AF) using implantable loop recorders (ILRs) in patients undergoing open chest cardiac surgery. METHODS AND RESULTS: Seventy-nine patients without a history of AF undergoing cardiac surgery underwent peri-operative high-resolution mapping of electrically induced AF and were followed 36 months after surgery using an ILR (Reveal XT™). Clinical and electrophysiological predictors of late POAF were assessed. POAF occurred in 46 patients (58%), with early POAF detected in 27 (34%) and late POAF in 37 patients (47%). Late POAF episodes were short-lasting (mostly between 2 min and 6 h) and showed a circadian rhythm pattern with a peak of episode initiation during daytime. In POAF patients, electrically induced AF showed more complex propagation patterns than in patients without POAF. Early POAF, right atrial (RA) volume, prolonged PR time, and advanced age were independent predictors of late POAF. CONCLUSIONS: Late POAF occurred in 47% of patients without a history of AF. Patients who develop early POAF, with higher age, larger RA, or prolonged PR time have a higher risk of developing late POAF and may benefit from intensified rhythm follow-up after cardiac surgery. CLINICALTRIALS.GOV NUMBER: NCT01530750.
Bidar et al. (Mon,) conducted a cohort in Patients undergoing open chest cardiac surgery (n=79). Implantable loop recorder (Reveal XT™) was evaluated on New-onset postoperative atrial fibrillation (POAF). Continuous monitoring with implantable loop recorders detected late postoperative atrial fibrillation in 47% of patients without prior AF during 36 months after cardiac surgery.