Risk factors for atrial fibrillation after lung cancer surgery: a meta-analysis

Background This study aims to explore potential risk factors for atrial fibrillation (AF) following lung cancer surgery through a meta-analysis. Methods PubMed, Embase, and the Cochrane Library databases were searched to identify all relevant studies on postoperative AF following lung cancer surgery. Inclusion criteria specified adult patients with lung cancer surgery who had clearly reported risk factors for AF. The search was conducted up to October 20, 2025. The quality of included studies was assessed using the standardized NOS scoring tool, and statistical analysis was performed using Stata 15. Data from all included studies were analyzed using a random-effects model. Results A total of 13 articles involving 20,701 lung cancer patients were included. The meta-analysis results suggest that age >65[OR = 1.68, 95% CI (1.30, 2.16)], Postoperative high BNP [OR = 3.82, 95% CI (1.43, 10.25)], male [OR = 1.82, 95% CI (1.35, 2.45)], smoking [OR = 1.72, 95% CI (1.35, 2.21)], hypertension [OR = 1.63, 95% CI (1.08, 2.48)], patients with TNM stage II lung cancer [OR = 2.21, 95% CI (1.22, 4.01)], transfusion [OR = 3.74, 95% CI (2.28, 6.12)] were associated with an increased risk of postoperative AF after lung cancer surgery. Conclusions This study suggesting that factors such as age >65 years, male gender, smoking, hypertension, elevated postoperative BNP levels, TNM stage II, and perioperative blood transfusion may be associated with an increased risk of postoperative AF in lung cancer patients. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251176315 , Prospero CRD420251176315.