April 26, 2026Journal of the American College of Cardiology
Postoperative atrial fibrillation and mortality after coronary artery bypass surgery
Key result
Postoperative AF after CABG linked to ~50% greater mortality risk at 4 to 5 years.
- adjusted OR 1.5
- P<0.001
- n=6,475
Why the study?
Atrial fibrillation is the most common arrhythmia after CABG, but whether its occurrence affects early or late mortality was unknown.
Comparison
Postoperative AF vs no postoperative AF
Design
Retrospective cohort study with case-matched analysis
Follow-up
Four to five years
Authors
Discussion
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Member takes
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Postoperative AF has long been considered a benign, self-limiting condition that converts to SR before hospital discharge in most cases. However, recent evidence suggests that the occurrence of postoperative AF is associated with patients with a larger burden of comorbidities, so causality between postoperative AF and long-term mortality remains unclear.”
“Our study suggests that POAF should not be regarded as equivalent to primary [nonvalvular A-fib] in terms of long-term thromboembolic risk”
AVAtul VermaElectrophysiologist, Southlake Regional Health Center, Canada
“This study, while adding to our information, is far from definitive and lays the groundwork for a properly designed randomized trial.”
Implication
Challenges benign view of post-CABG AF; leaves open causality and whether intervention reduces long-term mortality.
Study Design
Type
Cohort (n=6,475)
Multicenter
No
PICO
P
Population
Coronary artery bypass surgery (CABG) (n=6,475)
I
Intervention / Comparator
Postoperative atrial fibrillation vs No postoperative atrial fibrillation
O
Primary Outcome
Long-term survival at 4 to 5 years (retrospective cohort) — adjusted OR 1.5, p=<0.001
Main Result
Effect estimate: adjusted OR 1.5
Absolute Event Rate: 74% vs 87%
p-value: p=<0.001
Cite This Study
Villareal et al. (2004) conducted a cohort in Coronary artery bypass surgery (CABG) (n=6,475). Postoperative atrial fibrillation vs. No postoperative atrial fibrillation was evaluated on Long-term survival at 4 to 5 years (retrospective cohort) (adjusted OR 1.5, p=<0.001). Postoperative atrial fibrillation following CABG was an independent predictor of long-term mortality, with worse survival at 4 to 5 years compared to patients without AF (74% vs. 87%, p<0.0001).