Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation

Background Early postoperative atrial fibrillation ( EP o AF ) is associated with thromboembolic events, prolonged hospitalization, and development of late Po AF ( LP o AF ). It is, however, unknown if EP o AF can be predicted by intraoperative AF inducibility. The aims of this study are therefore to explore (1) the value of intraoperative inducibility of AF for development of both EP o AF and LP o AF and (2) the predictive value of de novo EP o AF for recurrence of LP o AF . Methods and Results Patients (N=496, 75% male) undergoing cardiothoracic surgery for coronary and/or valvular heart disease were included. AF induction was attempted by atrial pacing, before extracorporeal circulation. All patients were on continuous rhythm monitoring until discharge to detect EP o AF . During a follow‐up period of 2 years, LP o AF was detected by ECG s and Holter recordings. Sustained AF was inducible in 56% of patients. There was no difference in patients with or without AF before surgery ( P =0.159), or between different types of surgery ( P =0.687). In patients without a history of AF , incidence of EP o AF and LP o AF was 37% and 2%, respectively. EP o AF recurred in 58% patients with preoperative AF , 53% developed LP o AF . There were no correlations between intraoperative inducibility and EP o AF or LP o AF ( P >0.05). EP o AF was not correlated with LP o AF in patients without a history of AF ( P =0.116), in contrast to patients with AF before surgery ( P <0.001). Conclusions Intraoperative AF inducibility does not predict development of either EP o AF or LP o AF . In patients with AF before surgery, EP o AF is correlated with LP o AF recurrences. This correlation is absent in patients without AF before surgery.