Different POAF assessment methods (continuous telemetry, telemetry plus daily ECG, daily ECG) showed no significant difference in POAF incidence after cardiac surgery (27%, 27%, and 19%; P>0.05).
Meta-Analysis (n=197,774)
Does the assessment method and definition of postoperative atrial fibrillation influence its reported incidence and association with clinical outcomes in patients undergoing cardiac surgery?
The incidence of postoperative atrial fibrillation and its association with adverse outcomes are generally not influenced by the assessment method or definition used, except in patients undergoing isolated CABG.
p-value: p=>0.05
Background Postoperative atrial fibrillation (POAF) is the most frequent complication of cardiac surgery. Despite clinical and economic implications, ample variability in POAF assessment method and definition exist across studies. We performed a study‐level meta‐analysis to evaluate the influence of POAF assessment method and definition on its incidence and association with clinical outcomes. Methods and Results A systematic literature search was conducted to identify studies comparing the outcomes of patients with and without POAF after cardiac surgery that also reported POAF assessment method. The primary outcome was POAF incidence. The secondary outcomes were in‐hospital mortality, stroke, intensive care unit length of stay, and postoperative length of stay. Fifty‐nine studies totaling 197 774 patients were included. POAF cumulative incidence was 26% (range: 7.3%–53.1%). There were no differences in POAF incidence among assessment methods (27%, range: 7.3%–53.1% for continuous telemetry, 27% range: 7.9%–50% for telemetry plus daily ECG, and 19% range: 7.8%–42.4% for daily ECG only; P >0.05 for all comparisons). No differences in in‐hospital mortality, stroke, intensive care unit length of stay, and postoperative length of stay were found between assessment methods. No differences in POAF incidence or any other outcomes were found between POAF definitions. Continuous telemetry and telemetry plus daily ECG were associated with higher POAF incidence compared with daily ECG in studies including only patients undergoing isolated coronary artery bypass grafting. Conclusions POAF incidence after cardiac surgery remains high, and detection rates are variable among studies. POAF incidence and its association with adverse outcomes are not influenced by the assessment method and definition used, except in patients undergoing isolated coronary artery bypass grafting.
Perezgrovas‐Olaria et al. (Sat,) conducted a meta-analysis in Postoperative atrial fibrillation after cardiac surgery (n=197,774). POAF assessment method (continuous telemetry, telemetry plus daily ECG, daily ECG only) vs. Different assessment methods was evaluated on POAF incidence (p=>0.05). Different POAF assessment methods (continuous telemetry, telemetry plus daily ECG, daily ECG) showed no significant difference in POAF incidence after cardiac surgery (27%, 27%, and 19%; P>0.05).
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