Key result
Postoperative AF complicates ~30% of rheumatic valve surgeries, strongly linked to left atrial diameter and age.
Why the study?
Atrial fibrillation after cardiac surgery impacts 10 to 65% of patients and is associated with stroke and other systemic embolic manifestations.
Cohort (n=346)
No
In patients undergoing rheumatic heart valve surgery, postoperative atrial fibrillation occurs in nearly 30% and is strongly predicted by older age, male gender, left atrial diameter, and preoperative ejection fraction.
Postoperative AF risk stratification by age and left atrial size may guide monitoring in rheumatic valve patients; extends evidence but requires prospective validation.
Background Atrial fibrillation after cardiac surgery (AFACS) impacts 10 to 65% of patients. AFACS is associated with stroke and other systemic embolic manifestations. Methods Patients at our hospital who underwent rheumatic valve surgery procedures including aortic valve replacement (AVR), mitral valve replacement (MVR), AVR with coronary artery bypass grafting (CABG), MVR with CABG, or AVR and MVR with/without CABG were included in this study in the period from 2002 to 2017. Results In total, 346 patients were included in the current analysis, with a mean age of 51.6 ± 16.1 years, and 51% were males. AFACS was documented in 102 patients (29.9%) . Univariate predictors of AFACS included age, gender, body mass index (BMI), operation type, left ventricular ejection fraction (EF), left atrial (LA) diameter, previous history of AF, use of aldosterone antagonists more than a month before surgery, use of diuretics more than a month before surgery, length of ICU stay, total length of stay, cross-clamp time more than 90 minutes, pump time more than 120 minutes, postoperative acute kidney injury, left ventricular dimensions. By multivariate analysis, only age (p = 0.028, AOR = 10.6), male gender (p = 0.021, AOR = 3.4), type of surgery (p = 0.034, AOR = 7.12), history of AF (p = 0.018, AOR = 2.32), BMI (p < 0.001, AOR = 3.91), EF before surgery (p ≤ 0.001, AOR = 3.91), and LA diameter (p = 0.0051, AOR = 18.23) were independent predictors of AFACS. Conclusion This study identifies risk factors associated with the development of atrial fibrillation after rheumatic valve heart surgery. Older patients, male gender, type of surgery, preoperative AF, BMI, EF before surgery, and LA diameter are independent predictors of AF after cardiac valve surgery.
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Ibrahim et al. (2022) conducted a cohort in Rheumatic heart valve surgery (n=346). Rheumatic valve surgery was evaluated on Atrial fibrillation after cardiac surgery (AFACS). Atrial fibrillation after cardiac surgery occurred in 29.9% of patients undergoing rheumatic valve surgery, with left atrial diameter (AOR 18.23) and age (AOR 10.6) as strong independent predictors.
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