Why the study?
Postoperative atrial fibrillation (POAF) is a frequent complication after cardiac surgery, but its underlying mechanisms remain uncertain, specifically whether it results from irreversible atrial fibrosis or transient autonomic dysfunction.
Is postoperative atrial fibrillation driven by irreversible atrial fibrosis or transient autonomic dysfunction in patients undergoing cardiac surgery?
Population
4030 participants, including 16 healthy volunteers and 4014 cardiac surgery patients
Comparison
Atrial fibrosis quantification (18F-AlF-FAPI-PET-MRI) and perioperative HRV analysis according to POAF occurrence
Design
Prospective observational study
Key result
Postoperative atrial fibrillation was associated with transient autonomic co-activation, reflected by higher HRV indices (P<0.001), rather than irreversible atrial fibrosis (P>0.05).
Authors
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Hypothesis-generating for atrial fibrosis in CVD-related arrhythmias; prospective studies needed before clinical adoption.
Observational (n=4,030)
Is postoperative atrial fibrillation driven by irreversible atrial fibrosis or transient autonomic dysfunction in patients undergoing cardiac surgery?
p-value: p=<0.001
Postoperative atrial fibrillation appears to be driven by transient autonomic disequilibrium rather than irreversible atrial fibrosis, suggesting that early autonomic stabilization could be a key preventive strategy.
Zhang et al. (2026) conducted an observational in Postoperative atrial fibrillation (n=4,030). Postoperative atrial fibrillation (POAF) vs. Non-POAF patients was evaluated on Atrial fibrosis burden and heart-rate-variability (HRV) indices (p=<0.001). Postoperative atrial fibrillation was associated with transient autonomic co-activation, reflected by higher HRV indices (P<0.001), rather than irreversible atrial fibrosis (P>0.05).